When a polycystic bleb forms after a filtering procedure for glaucoma, aqueous flows across the conjunctiva.1-3 This has been demonstrated by dilution of fluorescein applied to the bleb area. The dark, nonfluorescent undiluted dye becomes a brilliant greenish-orange upon contact with aqueous.
Another method of demonstrating that aqueous can pass transconjunctivally is by eccentric perilimbal suction cup analysis.4,5 When a perilimbal suction cup is centered over a filtering bleb and connected to negative pressure, aqueous collects within the cup. This method essentially accelerates and augments transconjunctival flow. If a continuous flow of aqueous is necessary to maintain a patent sclerostomy and induce a functioning cystic bleb, then the technique of augmenting flow by eccentric suction might aid a faltering bleb.
This communication describes the technique of eccentric suction of fistulizing sites with the perilimbal suction cup apparatus. It will be demonstrated that a faltering filtering bleb may be
GALIN MA, BARAS I, CAVERO R. Stimulation of a Filtering Bleb. Arch Ophthalmol. 1965;74(6):777-780. doi:10.1001/archopht.1965.00970040779007