Autologous blood injection for late-onset filtering bleb leak

PURPOSE: To report the outcomes of autologous blood injections for late-ons et filtering bleb leak. METHODS: Retrospective chart review of all eyes that had autologous blood i njection(s) for filtering bleb leak occurring at least 2 months after trabe culectomy at the Indiana University Medical Center. Successful treatment wa s defined as resolution of the bleb leak and no need for additional glaucom a medications. Failure was defined as a persistent bleb leak, intraocular p ressure greater than 21 mm Hg, or the occurrence of a vision-threatening ev ent related to the procedure. RESULTS: Thirty-two eyes of 31 patients had autologous blood injection for filtering bleb leak and were followed for a mean of 4.9 months (SD, 9.2; ra nge, 1 to 37 months). Twenty-three eyes (72%) were outright failures becaus e of persistence of the leak. Nine eyes (28%) had an initially successful o utcome, but the success rate decreased over time as bleb leaks recurred in three of the nine eyes at 5, 6, and 37 months. No patient, characteristics correlated with outcome. Mean intraocular pressure increased from pretreatm ent to final examination (4.5 to 6.5 mm Hg, P = .003). Mean logarithm of mi nimal angle of resolution (logMAR) vision remained unchanged from pretreatm ent to final examination (P = .55). Blood seepage into the anterior chamber after autologous blood injection was common but transient. CONCLUSIONS: Autologous blood injection is of limited success in treating l ate-onset filtering bleb leak. (Am J Ophthalmol 2001;132:36-40. (C) 2001 by Elsevier Science Inc. All rights reserved).