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April 1993

Bleb Leak With Hypotony After Laser Suture Lysis and Trabeculectomy With Mitomycin C

Author Affiliations

Providence, RI

Arch Ophthalmol. 1993;111(4):427-428. doi:10.1001/archopht.1993.01090040017004

To the Editor.  —We read with interest Schwartz and Weiss' report1 of two cases of persistent bleb leak with hypotony following argon laser suture lysis in the August 1992 issue of the Archives. The authors reported late wound leaks following argon laser suture lysis in two patients who had undergone trabeculectomy and received intraoperative mitomycin C. Though much still needs to be learned about antimetabolites, filtering surgery, and the postoperative wound treatment of patients with glaucoma, we believe a modification in the power settings and wavelength of the laser energy delivered may help to reduce the potential complication of bleb leaks associated with laser suture lysis.For laser suture lysis we routinely use the krypton red laser and the Hoskins lens with the following parameters: 250 mW of power, duration of 0.1 second, and a spot size of 50 μm. In our experience, with good visualization and focus, only

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