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Letters |

Slitlamp–Optical Coherence Tomography–Guided Needling of Failing Filtering Blebs

Tanuj Dada, MD; Sujith Vengayil, MD; Ritu Gadia, MD, DNB; Viney Gupta, MD; Ramanjit Sihota, MD, FRCS
Arch Ophthalmol. 2008;126(2):284-286. doi:10.1001/archophthalmol.2007.55.
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Slitlamp anterior segment optical coherence tomography (SL-OCT) (Heidelberg Engineering, Heidelberg, Germany) allows for direct imaging of filtering blebs after trabeculectomy and can be used to assess the internal anatomy and function of these blebs. Needling with subconjunctival injection of antifibrotic agents has been reported for failing blebs with encouraging results.14 We describe a new use of SL-OCT by performing SL-OCT–guided needling for restoration of bleb function.

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Slitlamp–optical coherence tomography–guided needling of a Tenon cyst. A, Optical coherence tomographic image of a Tenon cyst (arrow) prior to needling. B, Needling being done under slitlamp-adapted optical coherence tomography guidance. C, Optical coherence tomographic image showing the needle track (arrow). D, Postintervention image showing the elevated bleb with increased echogenicity.

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