Management of Overfiltering and Leaking Blebs With Autologous Blood Injection-Reply

In reply  Complications associated with intrableb autologous blood injection have included hyphema formation, vitreous hemorrhage,¹ and intraocular pressure spikes. Dr Chen et al describe an unusual case, in which an eye with a penetrating keratoplasty and recurrent toxoplasma retinochoroiditis underwent four intrableb autologous blood injections for management of postfiltration hypotony. Viscoelastic had not been injected intracamerally prior to the blood injections, and blood was noted in the anterior chamber after each procedure. This was followed by an episode of graft failure and reactivation of toxoplasma retinochoroiditis.The authors suggest that these adverse events may have been potentiated by intrableb autologous blood injection with spillover of blood into the anterior chamber. Although the graft failure related to blood in the anterior chamber may be an interesting possibility, it may also be a circumstantial one. In this complex eye, graft rejection may have been precipitated by factors such as prolonged hypotony,