Reconstruction of a Leaking Filtering Bleb after Trabeculectomy Using Amniotic Membrane Transplantation and Contralateral Conjunctival Autograft: A Case Report

Abstract

Purpose: To describe the successful reconstruction of a leaking filtering bleb with necrotic conjunctiva long after trabeculectomy, using a double-layer amniotic membrane transplantation (AMT) combined with a contralateral conjunctival autograft.

Methods: A 63-year-old woman developed a thin, avascular, leaking bleb ten years after trabeculectomy with mitomycin-C. After infection control with fortified antibiotics, reconstruction was performed using AMT over the scleral flap, a contralateral conjunctival–Tenon autograft, and an additional AM patch.

Results: The ocular surface healed uneventfully. At two months, the bleb was sealed with good filtration and stable intraocular pressure. Best-corrected visual acuity improved to 0.2 logMAR.

Conclusion: The combined use of amniotic membrane and contralateral conjunctival autograft offers an effective solution for late-onset bleb leaks when local conjunctiva is friable.

Keywords: Trabeculectomy; Filtering Bleb; Bleb Leak; Amniotic Membrane Transplantation; Conjunctival Autograft; Glaucoma Surgery; Late-Onset Complication; Ocular Surface Reconstruction

Citation

González PT, Díaz Barreda MD, García DP, Duarte JR, Ascaso Puyuelo FJ, Alperte JI. Reconstruction of a Leaking Filtering Bleb after Trabeculectomy Using Amniotic Membrane Transplantation and Contralateral Conjunctival Autograft: A Case Report. WebLog J Ophthalmol Vis Sci. wjovs.2026.a1706. https://doi.org/10.5281/zenodo.18382477