Successful surgery of a huge dissecting filtering bleb oriented by preoperative anterior segment OCT: A case report

Abstract

Dissecting filtering bleb is an uncommon complication of trabeculectomy. Documented surgeries eliminated the dissecting corneal portion without damaging the original filtering bleb. We report an 83-year-old man who presented with an unusual huge dissecting glaucoma filtering bleb encroaching the inferior margin of pupil for 7 years. Preoperative anterior segment-optical coherence tomography (AS-OCT) revealed an encapsulated and thin-walled bleb bulk, whose lower boundary lied below the corneoscleral limbus. Total excision of the dissecting bleb and phacoemulsification with intraocular lens implantation were performed. Postoperative best-corrected visual acuity (BCVA) and intraocular pressure were satisfactory. As a high-resolution and noninvasive approach, preoperative AS-OCT can provide critical information in surgical decision-making.