Glaucoma Bleb Repair Rs 500
Amniotic Membrane Transplantation for Symptomatic Overhanging Filtering Bleb
Encapsulated Filtering Blebs: Medical Management and Surgical Bleb Revision
Free Conjunctival Autograft in the Mgt. of Chronic Hypotony
Management of Late Leaking Filtering Blebs
Surgical Management and Histopathology of Dissecting Glaucoma Filtering Bleb
Surgical Management of Leaking Filtering Blebs
Surgical Repair of Sclero-Limbal Perforation after Enzymatic Sclerostomy using Scleral Patch Graft
Amniotic Membrane Transplantation for Symptomatic Overhanging Filtering Bleb
Author: Dr Mandal Anil Kumar
Year of Publication: March 2002
Duration: 08:40 min
This video demonstrates the surgical revision of a filtering bleb that became full-blown four years after a patient underwent trabeculectomy with Mytomicin-C. It takes the viewer through the steps of dissecting the overhanging portion, excising the bleb and grafting the area with amniotic membrane. This is the first documentation of amniotic membrane grafting following partial excision of an overhanging filtering bleb.
Award: C.S.Reshmi Award in AIOS Conference 2004, Varanasi
Encapsulated Filtering Blebs: Medical Management and Surgical Bleb Revision
Author: Dr Mandal Anil Kumar
Year of Publication: 1998
TRT: 15 minutes
Presents the management strategy of encapsulated blebs following trabeculectomy. Medical therapy consisted of digital compression, topical steroids and antiglaucoma medications. Mitomycin C-augmented excisional bleb revision (EBR) was performed in cases of failed medical therapy. The present video highlights the microsurgical technique of EBR and photodocumentation of the clinical course of medically as well as surgically treated patients.
Free Conjunctival Autograft in the Management of Chronic Hypotony when Compression Sutures Failed
Author: Dr Mandal Anil Kumar
Year of Publication: March 2004
TRT: 08:25 minutes
Demonstrated here is the technique for the management of chronic hypotony due to overfiltration that persisted even after compression sutures were placed. This video illustrates the surgical procedure of free, autologous conjunctival grafting that included transplanting a large graft from the superotemporal bulbar area of the same eye to the filtering site. Management of chronic hypotony is challenging, and in case of a large bleb area with surrounding scarring, conjunctival autografting offered itself as a good and effective modality of treatment. It not only controlled the hypotony but also proved to be a viable option when compression sutures had failed.
Management of Late Leaking Filtering Blebs
Author: Dr Mandal Anil Kumar
Year of Publication: 1998
TRT: 9:50 minutes
This video demonstrates the management of three patients with late leaking filtering blebs. A step-wise management strategy was employed in which conservative therapy was tried first, followed (if necessary) by surgical treatment. Case 1 required over-turning partial thickness scleral autograft because of brisk leakage. Case 2 became successful with bandage contact lens application. Case 3 was managed by sliding conjunctival flap. All the patients had resolution of bleb leaks and restoration of the functioning blebs with adequate IOP control and visual recovery. Choice of surgical approach should be individualised depending on site and size of leaking fistula, briskness of leakage, health of adjacent sclera or conjunctiva.
Repair of Leaking Blebs
Author: Dr Garudadri Chandra Sekhar
Year of Publication: 1997
TRT: 11 minutes
Glaucoma filtering procedures have evolved from full thickness surgeries to guarded filtration procedures to avoid early post-operative shallow chambers and delayed bleb leaks and endophthalmitis. Pharmacological modulation of trabeculectomy has once again brought in the complications of endophthalmitis and bleb leaks. This video presentation demonstrates some surgical techniques for the repair of leaking blebs that do not respond to conservative measures. It presents the microsurgical technique as performed in three cases.
Surgical Management and Histopathology of Dissecting Glaucoma Filtering Bleb
Author: Dr Mandal Anil Kumar
Year of Publication: 1998
TRT: 11:40 minutes
Large filteing blebs that evolve after trabeculectomies can be bothersome to the patient, especially when overhanging the cornea. Surgical partial excision of the overhanging corneal part of the bleb was performed in one patient who had undergone earlier trabeculectomy with application of mitomycin-C. The area was covered by conjunctival advancement flap which was mobilized by a relaxing incision at the superior fornix. The surgical technique has been described and histopathology of the excised mitomycin filtering bleb has been discussed.
Surgical Management of Leaking Filtering Blebs
Author: Dr Mandal Anil Kumar
Year of Publication: 2002
Duration: 08:29 min
This video highlights the surgical management of leaking blebs depending on the presence or absence of a healthy and adequate surrounding conjunctiva. Conjunctival advancement flap is one method illustrated in which undermining of the healthy conjunctiva is conducted to allow mobilization and anterior positioning at the limbus of the freshly cut conjunctival edge, covering the filtration site. In case of severe scarring with difficult conjunctival mobilization, conjunctival auto grafting is done, as high lighted in the other case that includes transplanting a free autograft from the superior bulbar area to the filtering site.
Surgical Repair of Sclero-limbal Perforation after Enzymatic Sclerostomy using Scleral Patch Graft
Author: Dr Mandal Anil Kumar
Year of Publication: March 2004
Duration: 07:14 min
This video demonstrates a simple technique for the surgical repair of a sclerolimbal perforation due to enzymatic sclerostomy. Collagenase enzyme was applied using a micro applicator for 22 hours, which resulted in a perforation at the implant site. The operated eye was in the absolute stage of glaucoma. The perforation was managed using eyebank donor sclera trephined to cover the entire area of leak. The prolapsed uveal tissue was abscised and then an adequate anterior vitrectomy was done. A conjunctival advancement flap was used to ensure watertight coverage of the graft. Intraoperatively and at 6 weeks postoperatively, the anterior chamber was well formed and the graft had taken well. IOP was well controlled only on Timolol maleate eyedrops.
Management of Bleb Leak
Author: Dr Sirisha Senthil
Year of Publication: 2008
Duration: 09:40 min
A leaking filtering bleb is a serious vision-threatening complication of glaucoma surgery. It may occur any time following glaucoma filtering surgery. If left untreated, it may lead to serious complications like blebitis and endophthalmitis.
We have demonstrated a novel and easy technique of repair of early bleb leak with conjunctival autograft using fibrin glue, and current surgical techniques of choice to repair a late leaking bleb. The chances of complications arising after surgery are minimal and the techniques ensure a high success rate.