ABSTRACT
The purpose of this study is to evaluate the safety and efficacy of conjunctival advancement with or without bleb excision for repair of lateonset bleb leaks. Sixteen eyes of sixteen patients were included in this study with failure of conservative treatment. Eight eyes underwent conjunctival advancement over the preexsting bleb [Group I] and eight eyes treated with conjunctival advancement with bleb excision [Group II]. Success was defined as resolution of the bleb leak, intraocular pressure [lOP] less than 21 mm Hg without glaucoma Medication and No appearance of vision-threatening adverse event. Success rate was 75% in group I and 62.5% in group II with a mean [ +/- SD] follow-up 17.2 +/- 7.2 and 15.5 +/- 6.7 months respectively. The mean [MD] prerevision lOP was 4.9 +/- 3.2 [group I] and 5.2 +/- 3.4 mm Hg [group II] and mean [MD] postrevision lOP was 12.6 +/- 4.4 [group I] and 14.4 +/- 5.3 mm Hg [group II]. The difference between prerevision lOP [p = 0.45], postrevision lOP [p = 0.25], and visual acuity changes [p= 0.5] between group I and II were statistically non-significant. Comparison between prerevision and postrevision lOP in group I and II revealed significant elevation of lOP after bleb revision [p= 0.01 and 0.006- respectively]. Conjunctival advancement with bleb preservation [group I] is effective and simpler technique than with bleb excision [group II]. In addition to minimal risk of lOP elevation