Transconjunctival oozing and point leak of aqueous humor from filtering bleb after trabeuclectomy

ABSTRACT

To estimate the prevalence and identify factors related to late-onset transconjunctival aqueous oozing and point leak from functioning blebs after trabculectomy with 5-flurouracil [5-Fu] or mitomycin C. Two hundred seven consecutive patients [207 eyes] with functional blebs were examined. The seidel test was performed with extended observation up to 15 seconds. Oozing was identified as transonjunctival aqueous egress without interruption of the conjunctival tissue or aqueous stream on the bleb wall. Logistic regression analyses of oozing and point leak in 168 eyes with an avascular area were performed using independent variables, including age, glaucoma diagnosis, prior incisional surgery, antimetabolite use, concurrent cataract surgery, postoperative follow-up period, intraocular pressure [IOP], concurrent glaucoma therapy, bleb size, and avascualr area size. Of 207 eyes, 27 eyes [13%] had oozing and 6 eyes [2.8%] had point leak. Intraocualr pressure was significantly lower and an avascualr area was more frequent in eyes with oozing or leak than in eyes without [P < .00 1]. Logistic regression analysis revealed that oozing was significantly more common after use of 5-FU than mitomycin C, whereas point leak was associated with a larger avascular area. After tabeculectomy with antimetabolites, transconjunctival oozing is much more frequent than point leak. Oozing was significantly associated with the use of 5-FU and point leak with a larger avascualr area in the bleb