Dr. SUNITHA PARAMESHWARA

, Dr. RACHEL JOSEPH

A leaky bleb is dreaded by every glaucoma surgeon, and an added scleral button hole in the

trabeculectomy flap makes it a night mare. Here we present a simple technique to save your

bleb.

A 60yr old male patient presented with hypotonus eye on post-op day-3 post trabeculectomy

surgery. On exploration,as anticipated gaping of the sutured button hole was seen. To rectify this, we

decided to fashion a partial thickness scleral patch graft. This graft was placed and secured

just at the site of button hole taking care not to block the aqueous flow through the apical

area. The conjunctiva was closed with continuous suture at the corneo-scleral junction. This

technique ensured sealing the leak and saving the bleb.