J Korean Ophthalmol Soc.  2010 May;51(5):790-793.

Baerveldt Tube Implantation After Bleb Dysesthesia: Case Report

• Kang KD
• Kim YD
• Abdul Majid AS
• Kwag JH
• Salmon J
• Yim HB

Abstract

PURPOSE
To report a case of bleb dysesthesia successfully treated after Baerveldt tube implantation.
CASE SUMMARY
A 37-year-old woman presented with a history of persistent foreign body sensation and pain in the left eye. The patient was referred to our hospital and was diagnosed as having had plateau iris syndrome. Having shown no improvement with conservative management, she eventually received trabeculectomy in the left eye six months prior to her current presentation. Under the impression of bleb dysesthesia, she received artificial tears and a bandage contact lens. These, however, failed to alleviate her symptoms. She then had a compression suture of the bleb and bleb revision. These were performed sequentially but neither was effective. Finally, a Baerveldt tube implantation was performed successfully, and, three months later, bleb revision was performed using a donor sclera, which resulted in no further complaint of ocular discomfort.
CONCLUSIONS
Bleb dysesthesia, although not a common postoperative complication, can occur after trabeculectomy and can be successfully treated with Baerveldt tube implantation. Patients should receive appropriate counseling and advice on bleb dysesthesia prior to undergoing trabeculectomy.

Keyword

Baerveldt tube; Bleb dysesthesia; Trabeculectomy

MeSH Terms

Adult
Bandages
Blister
Counseling
Eye
Female
Foreign Bodies
Humans
Iris
Ophthalmic Solutions
Paresthesia
Postoperative Complications
Sclera
Sensation
Sutures
Tissue Donors
Trabeculectomy
Ophthalmic Solutions

Figure

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  Figure 1. Initial visual field test showing arcuate scotoma in the left superior visual field. Fundus image of the patient's left eye is also shown.

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  Figure 2. (A) Slit-lamp photograph demonstrating punctate epithelial erosions of the cornea adjacent to the bleb. (B, C) Slit-lamp photograph of the left eye. Note a large superior filtering bleb with a high profile.

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  Figure 3. Slit-lamp photograph taken 6 month after Baerveldt tube implantation. Patient was symptom free and the intraocular pressure was satisfactorily maintained.

Reference

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