Journal List > J Korean Ophthalmol Soc > v.53(9) > 1009180

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Jung, Lee, Kim, and Sohn: Surgical Treatment of Overhanging Bleb Using Indocyanin Green Dye
Case Report
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(9): 1364-1367.

Published online: 17 September 2012

DOI: https://doi.org/10.3341/jkos.2012.53.9.1364

Surgical Treatment of Overhanging Bleb Using Indocyanin Green Dye

Jong Jin Jung, MD, Jung Jin Lee, MD, Hwang Ki Kim, MD, Yong Ho Sohn, MD, PhD

Myung-Gok Eye Research Institue, Department of Ophthalmology, Kim's Eye Hospital, Konyang University, Seoul, Korea.

Address reprint requests to Yong Ho Sohn, MD, PhD. Department of Ophthalmology, Kim's Eye Hospital, #136 Yeongsin-ro, Yeongdeungpo-gu, Seoul 150-902, Korea. Tel: 82-2-2639-7815, Fax: 82-2-2633-3976, yhsohn@kimeye.com

Received 25 January 2012       Accepted 24 June 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To report a case of overhanging bleb excision using Indocyanin green (ICG) dye.

Case summary

A 71-year-old man visited our clinic complaining of a white corneal foreign body in his left eye. The patient underwent mitomycin-assisted trabeculectomy surgery 8 years prior. Slit lamp examination revealed a large overhanging bleb. Because of its large size, surgical excision using ICG dye was performed. After excision surgery, the IOP was well controlled and no anterior chamber inflammation was observed. Two months later, the IOP was still stable at 11 mm Hg and no recurrence of the overhanging bleb was found.

Conclusions

ICG dye is useful in delineating between a functioning bleb and a non-functioning overhanging bleb. ICG dye-assisted bleb excision is a useful method for decreasing complications such as aqueous humor leakage and damage of the original bleb.

Keywords: Indocyanin green dye, Overhanging bleb, Trabeculectomy

Figures and Tables

Figure 1
(A) Anterior segment photography of preoperative overhanging bleb. (B) The bleb covers 1/3 of the upper nasal side cornea.
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Figure 2
(A) The postoperative 2 month anterior segment slit lamp photography. (B) The overhanging bleb was completely removed. (C) Remaining functioning bleb is still multicystic and well elevated.
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Figure 3
(A) Preoperative overhanging bleb. (B) ICG dye injection into the functioning bleb for separation from the non-functioning bleb. (C) Delineation of the bleb margin from the cornea using Vannas scissor. (D) Peeling of remaining non-functioning overhanging bleb by spatula. (E) Removal of the overhanging bleb. (F) No leakage found.
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