Intracameral Air and Fibrin Glue for the Management of Late Bleb Leak following Glaucoma Surgery

BACKGROUND AND OBJECTIVES: To report a case of delayed-onset bleb-associated endophthalmitis (BAE) with bleb leak successfully managed with pars plana vitrectomy, intravitreal antibiotics, intracameral air, and fibrin glue. PATIENT AND METHODS: A 66-year-old pseudophakic female presented with BAE and bleb leak. A 25-gauge pars plana vitrectomy, cultures, and intravitreal antibiotics and steroid injections were performed. The infusion was switched to air filling the anterior chamber and bleb with air. Fibrin glue (Tisseel®) was applied over the leaking bleb. RESULTS: BAE and bleb leak resolved with return of visual acuity to 20/25 and a functioning bleb with no recurrence of bleb leak after 1 year of follow-up. CONCLUSION: The combination of intracameral air and fibrin glue may have a role in the management of bleb leaks.