Treatment of Postfiltration Bleb Leaks with Autologous Blood

Smith, M F; Magauran, Raymond G.; Betchkal, Janet; Doyle, J. William

doi:10.1016/s0161-6420(95)30941-4

Cited by 62 publications

(34 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Blood is a well-known mediator of inflammation and indeed injections of blood are used to reduce aqueous drainage in hypotonous eyes. 14 In large amounts and possibly not only in the anterior chamber but also in the trabeculectomy ostium and bleb subconjunctival tissue, blood would mediate conjunctival scarring and trabeculectomy failure. The haemorrhagic tendency in warfarinised patients and subsequent risk of bleb failure may be an indication for the use of intraoperative antimetabolites.…”

Section: Discussionmentioning

confidence: 99%

The effect of aspirin and warfarin therapy in trabeculectomy

Cobb

Chakrabarti

Chadha

et al. 2006

Eye

View full text Add to dashboard Cite

Aim The management of patients on antiplatelet and anticoagulation therapy (APACT) in glaucoma surgery currently has no specific recommendations. We aimed to establish the risk of haemorrhagic complications and surgical outcome in patients on APACT in glaucoma surgery. Methods We retrospectively examined 367 consecutive trabeculectomies performed between 1994 and 1998. Preoperatively 60 (16.4%) patients were on APACT (55 on aspirin and five on warfarin). The incidence of hyphaema and haemorrhagic complications between patients with and without APACT was documented. Surgical success was defined in two categories as an intraocular pressure (IOP) o21 mmHg and an IOP o16 mmHg 2 years following trabeculectomy with and without antiglaucoma medication. Results None of the patients on aspirin suffered significant intra or postoperative haemorrhage. Aspirin was associated with a significantly higher risk of hyphaema (P ¼ 0.0015) but this was not found to significantly affect IOP control at 2 years. Patients on warfarin suffered haemorrhagic complications and trabeculectomy failure. Conclusions Aspirin appears to be safe to continue with during trabeculectomy. Patients on aspirin have an increased risk of hyphaema following trabeculectomy. This however does not appear to affect surgical outcome. Warfarinised patients are at risk of serious bleeding complications. They require careful monitoring pre-and postoperatively and are at risk of trabeculectomy failure.

show abstract

Section: Discussionmentioning

confidence: 99%

The effect of aspirin and warfarin therapy in trabeculectomy

Cobb

Chakrabarti

Chadha

et al. 2006

Eye

View full text Add to dashboard Cite

show abstract

“…The benefit of either intrableb or peribleb blood injection after filtering surgery for cases of hypotonous maculopathy which results from either leaking blebs or overfiltering has been noted (Wise 1993;Nuyts et al 1994;Leen et al 1995;Smith et al 1995). Some clinicians reported that peribleb blood injection (Smith et al 1995) might be safer than intrableb injection to decrease the incidence of hyphema (Leen 1996), which could cause visionthreatening complications (Lu et al 1997).…”

Section: Discussionmentioning

confidence: 99%

“…Some clinicians reported that peribleb blood injection (Smith et al 1995) might be safer than intrableb injection to decrease the incidence of hyphema (Leen 1996), which could cause visionthreatening complications (Lu et al 1997). We chose peribleb autologous blood injection to keep blood from entering under the flap.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Autologous blood injection for marked overfiltration early after trabeculectomy with mitomycin C

Okada

Tsukamoto

Masumoto

et al. 2001

Acta Ophthalmologica Scandinavica

View full text Add to dashboard Cite

ABSTRACT.Purpose: After trabeculectomy with mitomycin C, extremely low intraocular pressure (IOP) with excess filtration may cause hypotonous maculopathy in the early postoperative period. We evaluated the effect of injecting autologous blood on reversing early postoperative marked hypotony after trabeculectomy with mitomycin C. Methods: Trabeculectomy with mitomycin C was performed in 258 eyes between 1994 and 1998. Peribleb autologous blood injection was performed in five eyes in which pressure patches were ineffective in reversing excess filtration. Approximately 0.1 to 0.3 ml of whole unclotted blood was slowly injected at least 3 mm from the edge of the flap using a sterile 27-gauge needle. Results: None of these eyes developed hypotonous maculopathy after injection. After a mean 31-month follow-up, all eyes had well-controlled IOP and visual acuity in three eyes was much improved. Postoperative complications included mild IOP elevation in one eye treated with laser suturelysis, and fibrinous pupillary membrane in one eye. Conclusion: In the early postoperative period, autologous blood injection is effective in reversing excess filtration.

show abstract

“…Complicações graves podem ocorrer tardiamente nesses casos, como endoftalmite infecciosa e maculopatia hipotônica (1)(2) . O tratamento da bolha hiperfiltrante e do vazamento de humor aquoso é semelhante e inclui curativo oclusivo, lente de contato terapêutica com ou sem uso de cola de cianoacrilato, aplicação de ácido tricloroacético, cauterização focal, fotocoagulação com ou sem corantes para aumentar a absorção do laser, crioterapia, uso de supressores de produção do humor aquoso, enxerto lamelar com esclera de cadáver, injeção de sangue autólogo na bolha filtrante, revisão cirúrgica e diferentes técnicas de sutura (1)(2)(3)(4)(5)(6)(7) . Os resultados são muitas vezes desanimadores, pois a manipulação dessas bolhas filtrantes avasculares, com paredes finas e friáveis, acaba por esgarçar a conjuntiva que freqüentemente necessita ser ressecada e substituída por um novo tecido (7) .…”

Section: N T R O D U ç ã Ounclassified

Uso de membrana amniótica no tratamento de complicações pós-trabeculectomia

Gomes¹,

Fernandes²,

Komagome³

et al. 2001

Arq. Bras. Oftalmol.

View full text Add to dashboard Cite

Uso de membrana amniótica no tratamento de complicações p ó s -t r a b e c u l e c t o m i aMétodos: Quatro olhos de 4 pacientes que apresentavam complicações pós-trabeculectomia com mitomicina-A (vazamento de humor aquoso com teste de Seidel +, 3 olhos, e bolha hiperfiltrante, 1 olho) foram submetidos à cirurgia para reconstrução da bolha filtrante com uso de membrana amniótica. Resultados: A média do tempo de seguimento foi de 5,75 meses (variação de 2 a 9 meses). Conseguiu-se resolução do quadro em todos os casos, sendo que em 1 caso necessitou-se de aplicação de cola e lente de contato para resolução do quadro. Em média, a epitelização ocorreu em 14,75 dias (variação de 8 a 21 dias). A acuidade visual melhorou em apenas 1 paciente e manteve-se inalterada nos outros 3 casos. Após as cirurgias, a pressão intra-ocular manteve-se sob controle com uso de medicação antiglaucomatosa tópica em todos os pacientes. Conclusão: O uso de membrana amniótica constitui uma opção viável para o tratamento do vazamento do humor aquoso e bolha hiperfiltrante pós-trabeculectomia resistentes ao tratamento convencional. Mais casos são necessários para melhor avaliar e refinar a técnica operatória.

show abstract

Treatment of Postfiltration Bleb Leaks with Autologous Blood

Cited by 62 publications

References 15 publications

The effect of aspirin and warfarin therapy in trabeculectomy

The effect of aspirin and warfarin therapy in trabeculectomy

Autologous blood injection for marked overfiltration early after trabeculectomy with mitomycin C

Uso de membrana amniótica no tratamento de complicações pós-trabeculectomia

Contact Info

Product

Resources

About