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Outcomes of surgical bleb revision at a tertiary Singapore eye hospital

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A Correction to this article was published on 05 September 2022

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Abstract

Purpose

To describe the outcomes of surgical bleb revisions from a tertiary glaucoma service in Singapore.

Methods

One hundred and thirty-one eyes of 129 patients who underwent surgical bleb revisions at the Singapore National Eye Centre between 2007 and 2014 were included in the study. The indications for bleb revision were: bleb-related infection (BRI), early and late bleb leak, early and late overfiltration, and bleb dysesthesia. Regression analysis was applied to elucidate risk factors.

Results

The mean age of the patients was 66 years, 62.6% were male, and 88.5% were Chinese. The majority of the eyes had primary glaucoma (79.4%). The mean interval from the initial trabeculectomy or phaco-trabeculectomy to the bleb revision was 58.8 months. The overall success rate was 69.5%. By Kaplan–Meier survival analysis, the overall cumulative success range fell from 78.6% to 49.1% over 10 years. Eyes with early bleb leak had lower surgical success compared to eyes with late bleb leak, early overfiltration and late overfiltration (P = 0.026, log-rank test). The IOP improved significantly post-operatively for eyes with BRI, early bleb leak, late bleb leak, early overfiltration and overfiltration (P < 0.05). Vision improved significantly in eyes with early overfiltration, but deteriorated in eyes with BRI (P < 0.05).

Conclusion

The overall success rate for surgical bleb revisions was good with complete resolution of the primary problem in the majority of cases. However, eyes with early bleb leak were less likely to have successful outcomes and should be monitored more closely post-operatively.

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Authors and Affiliations

  1. Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore

    Annabel C. Y. Chew, Shamira A. Perera & Ching Lin Ho

  2. Singapore Eye Research Institute, Singapore, Singapore

    Annabel C. Y. Chew, Hla Myint Htoon, Shamira A. Perera & Ching Lin Ho

  3. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Annabel C. Y. Chew, Shamira A. Perera & Ching Lin Ho

  4. Duke-NUS Graduate Medical School, Singapore, Singapore

    Annabel C. Y. Chew, Hla Myint Htoon, Shamira A. Perera & Ching Lin Ho

  5. Peregrine Eye and Laser Institute, Metro Manila, Philippines

    Carlo J. S. Rubio

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  1. Annabel C. Y. Chew
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  2. Hla Myint Htoon
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  3. Shamira A. Perera
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  4. Carlo J. S. Rubio
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Correspondence to Ching Lin Ho.

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The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

The study was approved by the institutional review board of the Singapore Eye Research Institute and Singapore National Eye Centre.

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Consent was not required as the study was conducted retrospectively from data obtained for clinical purposes.

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Consent was not required as the study was conducted retrospectively from data obtained for clinical purposes.

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Chew, A.C.Y., Htoon, H.M., Perera, S.A. et al. Outcomes of surgical bleb revision at a tertiary Singapore eye hospital. Int Ophthalmol 42, 443–453 (2022). https://doi.org/10.1007/s10792-021-02061-z

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  • DOI: https://doi.org/10.1007/s10792-021-02061-z

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