Clinical analysis of 17 patients with corneal invasion of filtering blebafter anti-glaucomatous filtering surgery / 眼科新进展

ABSTRACT

Objective To report a postoperative complication of corneal invasion of filtering bleb (CIFB) and the analysis of its diagnosis and treatment.Methods A retrospective analysis was conducted in 17 patients with CIFB collected from March 2006 to April 2017.They were treated according to the classification standards.Patients suffering the mild type with no obvious conjunctival post-adhesion received conservative observation;but patients with obvious adhesion were given acupuncture separation combined with 5-Fluorouracil filter follicular subconjunctival injection and eye massage.The moderate type with no progress was treated with the mild and mediumpartial filtration and amniotic membrane transplantation.For the severe ones,the conjunctiva filtering bleb was excised with lamellar keratoplasty and filtering bleb reconstruction.Finally,the clinical features,classification standards and the follow-up results were summarized.Results As for the clinical features,17 patients were treated with domeas the basement of the conjunctival incision,and received intraoperative mitomycin administration.For the patients with CIFB growing rapidly,the posterior synechiae of their filtering blebs had occurred and timely actions could slow down or stop its development.As for the classification standards,according to the degree of corneal invasion,there were 11 patients being mild type,5 patients being moderate types,and only 1 patients being severe type.After treatment,the progress stopped in all mild patients,while the moderate and severe types were not relapsed after treatment.Conclusion CIFB is different from overhanging filtering bleb.As a less common kind of filtering bleb complication,timely identification and appropriate treatments can effectively delay or even stop the progress of corneal damage to maintain the filtering surgery effects.