Collagen crosslinking in the management of leaking cystic blebs: a prospective study.
Choy Bonnie Nga Kwan, Zhu Ming Ming, Shum Jennifer Wei Huen, Ho Wing Lau, Chan Jonathan Cheuk Hung, Ng Alex Lap Ki, Lai Jimmy Shiu Ming
AI Summary
Collagen crosslinking effectively stopped leaking glaucoma blebs in a small study, offering a safe, non-invasive treatment option to strengthen conjunctiva and avoid immediate surgery.
Abstract
Purpose
To evaluate the effectiveness and safety of collagen crosslinking for leaking cystic blebs.
Methods
A prospective study was conducted on subjects with cystic bleb leaks without indications for urgent surgical intervention. Collagen crosslinking with riboflavin 0.1 % and ultraviolet A irradiation for 30 min was applied to the cystic bleb surface in five patients. Subjects were followed up for at least 20 weeks (mean: 35.5 ± 11.5 weeks) to monitor the length of time to the cessation of bleb leak, as well as visual acuity, intraocular pressure, and the presence of adverse effects arising from the treatment.
Results
Results showed that a single session of collagen crosslinking was effective in stopping cystic bleb leak. In two of the five subjects, the bleb leak subsided 1 week post-treatment, in one patient after 2 weeks, and in the two more complicated cases, after 4 weeks. This effect was maintained for a mean period of 33.5 ± 10.2 weeks after bleb leak cessation. Treatment was effective even in patients with friable conjunctiva following multiple surgical interventions and severe leak, although a longer period was needed for resolution of the bleb leak. The intraocular pressure and visual acuity were largely stable before and after treatment. No side effects or complications arose from this treatment.
Conclusions
We recommend a trial of collagen crosslinking on leaking cystic blebs without indications for immediate surgical interventions. It is a relatively easy, non-invasive, pain-free, and potential repeatable procedure for treating leaking cystic blebs, with the aim of strengthening the underlying pathological conjunctiva.
MeSH Terms
Shields Classification
Key Concepts5
A single session of collagen crosslinking with riboflavin 0.1% and ultraviolet A irradiation for 30 minutes was effective in stopping cystic bleb leak in five patients.
In two of five patients treated with collagen crosslinking for cystic bleb leaks, the bleb leak subsided 1 week post-treatment, in one patient after 2 weeks, and in two more complicated cases, after 4 weeks.
The effect of collagen crosslinking in stopping cystic bleb leak was maintained for a mean period of 33.5 ± 10.2 weeks after bleb leak cessation in five patients.
In five patients treated with collagen crosslinking for cystic bleb leaks, the intraocular pressure and visual acuity were largely stable before and after treatment, and no side effects or complications arose from this treatment.
Collagen crosslinking with riboflavin 0.1% and ultraviolet A irradiation for 30 minutes was applied to the cystic bleb surface in five patients with cystic bleb leaks without indications for urgent surgical intervention, who were followed up for at least 20 weeks (mean: 35.5 ± 11.5 weeks).
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