{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:06:43Z","timestamp":1790730403000,"version":"4.1.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,9]]},"abstract":"\n Purpose:<\/jats:title>\n To report long-term outcomes in eyes that developed late-onset bleb leak post trabeculectomy, with or without hypotony and\/or maculopathy, due to a scleral melt\/fistula and who required a scleral patch graft and conjunctival advancement for repair.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Retrospective, non-comparative, interventional case series over a decade (2010\u20132019), presenting with late bleb leak post-filtration-surgery. All cases required a scleral patch graft and conjunctival advancement for management via a standard technique, performed by an experienced glaucoma surgeon.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 18 eyes were included. Mean age was 51.5 \u00b1 10.2 years (95% CI [46.4\u201356.7]) and were followed up after repair for 52.4 \u00b1 26.9 months, 95%CI [39.1\u201365.8]. 66.7% eyes (\n n<\/jats:italic>\n = 12) had IOP \u22666 mmHg and also had hypotony maculopathy. None of the eyes presented with blebitis. 44.5% (\n n<\/jats:italic>\n = 8) eyes underwent phacoemulsification as significant cataract was present. LogMAR best-corrected visual acuity (BCVA) was 0.8 \u00b1 0.7 (95% CI [0.4\u20131.1]) prior to intervention and improved to 0.4 \u00b1 0.6 (95% CI[0.1\u20130.6],\n P<\/jats:italic>\n = 0.004). 22.3% (\n n<\/jats:italic>\n = 4) eyes had persistent choroidal folds but BCVA was improved. Mean pre-intervention intraocular pressure (IOP) was 6.3 \u00b1 3.8 mmHg (95% CI 4.4\u20138.2]) which increased to 12.1 \u00b1 2.9 mmHg (95%CI[10.6\u201313.5], (\n P<\/jats:italic>\n < 0.001). 27.8% (\n n<\/jats:italic>\n = 5) eyes needed laser suture lysis post repair to control IOP; two needed further surgical intervention. Number of anti-glaucoma medications at last follow-up was 0.4 \u00b1 0.9 (95% CI [\u22120.1\u20130.8],\n P<\/jats:italic>\n = 0.09). No serious complications were encountered.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Scleral patch graft and conjunctival advancement is a useful technique for repair of a scleral fistula post-filtering surgery, and this is recommended not only for the restoration of anatomy for prevention of infection and control of IOP, but also for visual rehabilitation.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijo.ijo_148_21","type":"journal-article","created":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T23:07:16Z","timestamp":1630537636000},"page":"2496-2501","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Long-term outcomes of blebs repaired with scleral patch graft and conjunctival advancement in late-onset leak post-trabeculectomy"],"prefix":"10.4103","volume":"69","author":[{"given":"Vanita","family":"Pathak Ray","sequence":"first","affiliation":[{"name":"Department of Glaucoma, Centre for Sight, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swathi V","family":"Badakere","sequence":"additional","affiliation":[{"name":"VST Centre for Glaucoma, L. 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Prasad Eye Institute, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,8,25]]},"reference":[{"key":"B1-20240828","first-page":"CD002897","article-title":"Intra-operative mitomycin C for glaucoma surgery","volume":"4","author":"Wilkins","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"B2-20240828","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1016\/S0161-6420(02)01069-2","article-title":"Efficacy and safety of mitomycin-C in primary trabeculectomy:Five-year follow-up","volume":"109","author":"Bindlish","year":"2002","journal-title":"Ophthalmology"},{"key":"B3-20240828","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1016\/S0161-6420(02)00965-X","article-title":"Delayed-onset bleb-associated endophthalmitis:Clinical features and visual acuity 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hypotony","volume":"26","author":"O'Rourke","year":"2020","journal-title":"Eur J Ophthalmol"},{"key":"B11-20240828","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/IJG.0b013e318184564e","article-title":"Outcome of bleb revision using scleral patch graft and conjunctival advancement","volume":"18","author":"Au","year":"2009","journal-title":"J Glaucoma"},{"key":"B12-20240828","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1097\/00061198-199812000-00011","article-title":"Use of autologous Tenon's capsule and scleral patch grafts for repair of excessively draining fistulas with leaking filtering blebs","volume":"7","author":"Morris","year":"1998","journal-title":"J Glaucoma"},{"key":"B13-20240828","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/S0002-9394(14)73658-X","article-title":"Partial-thickness scleral-patch graft in revision of trabeculectomy","volume":"115","author":"Clune","year":"1993","journal-title":"Am J 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