Abstract

Trabeculectomy is the surgical treatment of choice for many patients with glaucoma. Overall the success rate is reasonably high. A proportion of the procedures fail in early post operative period & a smaller proportion of the procedures fail, after a number of years. Bleb revision with needling can be done in early as well as late bleb failures with good success rate. Goal of needling is to re-establish the fistula from the anterior chamber to a subconjunctival bleb. Bleb needling has varying success rates, ranging from 30% to 94% with good long-term control. It is repeatable & avoids the risks of invasive surgery as well as the need for daily medications. Needling a previously viable bleb conserves the conjunctiva & allows faster recovery & fewer complications than repeat trabeculectomy, often with similar results. In this video proper technique & pearls of bleb needling in OPD as well as in OT is demonstrated along with the pre and post bleb needling pictures of bleb and AS OCT.