Overhanging glaucoma filtration bleb related to cataract surgery
A 74-year-old man presented with a three-year history of foreign body sensation in the right eye after cataract surgery. He underwent uneventful trabeculectomy with mitomycin C (MMC) in the right eye seven years ago. Slit-lamp examination revealed a large avascular filtration bleb overhanging on the cornea with a thin base connected to the conjunctiva. Preoperative ultrasound biomicroscopy (UBM) impressions were confirmed by leakage of aqueous from the incision intraoperatively. Surgical dissection and revision of the bleb was performed with satisfactory outcome. Histopathologic evaluation showed proliferation of fibrous tissue under the conjunctival epithelia with irregular cystoids change. The current case may be the first report of a post-trabeculectomy overhanging filtration bleb related to cataract surgery. The possible mechanism may be related to microleakage of the surgical wound after phacoemulsification which initiated the healing and scarring process.