Management of late-onset bleb leaks.

PURPOSE OF REVIEW: This paper reviews various methods of both medical and surgical management of late bleb leaks.

RECENT FINDINGS: The hood procedure without bleb removal may be preferred for small leaking blebs and autologous conjunctival bleb resurfacing for large leaking blebs. If hypotony is present preleak, revision of the underlying scleral flap may also be required.

SUMMARY: Blebs with late leaks are a major problem after glaucoma filtration surgery and can result in hypotony or endophthalmitis. Conservative treatment and laser therapy both have limited success in sealing the leaks and are not as effective as surgical management. Many surgical techniques are used, but none is universally successful.