Intrableb injection of autologous blood has been effective in reducing filtration and hypotony after trabeculectomy with adjunctive antifibrotic therapy and in closing a bleb leak.1-3 Elevation of intraocular pressure occurs as injected blood proteins presumably react with tissue factors to induce the formation of a fibrinfibronectin matrix1 that seals the bleb, defect or lines the inner bleb, thereby reducing transconjunctival flow. We report two cases of highly elevated intraocular pressure immediately after intrableb blood injection.
Report of Cases.
A 73-year-old woman with medically uncontrolled chronic open-angle glaucoma underwent uncomplicated initial trabeculectomy without adjunctive antifibrosis therapy. Eight months after surgery, hypotony maculopathy developed and she was referred for evaluation of her condition. Visual acuity was 20/400 OD, which was reduced from 20/25 OD. The bleb was avascular and limited to 2 clock hours. While the results of the Seidel test were negative, fluorescein on the bleb surface
Siegfried CJ, Grewal RK, Karalekas D, Rosenberg LF, Krupin T. Marked Intraocular Pressure Rise Complicating Intrableb Autologous Blood Injection. Arch Ophthalmol. 1996;114(4):492-493. doi:10.1001/archopht.1996.01100130488028