When good blebs go bad: remodeling a filtering bleb

It is possible to remodel filtering blebs, but much like a home remodeling project, a bleb remodeling should only be undertaken with a plan, a careful review of options, and the realization that it may become more involved than initially expected.

Key Points

San Francisco-Remodeling a filtering bleb is not unlike undertaking a remodeling project at home, according to Andrew G. Iwach, MD, associate clinical professor, University of California, San Francisco. Whether remodeling a bleb repair or a new kitchen, one must define the objectives, consider the various options to achieve those objectives, and customize an intervention.

"Timing is also important," Dr. Iwach said. "It's better to deal with a failing bleb than a failed bleb."

Several options exist for remodeling a bleb. Medical therapy, such as aqueous suppressants, sometimes can reduce the profile of a bleb, and if the bleb is not functioning enough, in some cases it can be remodeled by massage. Applying thermal energy, either through a laser or a disposable cautery unit, is another option, as is freezing the tissue around the bleb.