Surgical management of encapsulated filtering blebs.

Encapsulated filtering blebs associated with elevated intraocular pressure or symptomatic dellen formation, unresponsive to conservative therapy, developed in 24 of 222 eyes following glaucoma filtering surgery over a five-year period, an incidence of 11%. Nine of 13 eyes were treated successfully with primary needling of the bleb. Ten of 11 eyes were successfully treated with primary bleb revision. Four eyes were successfully treated with a combination of needling and surgical revision and one eye required cyclocryotherapy. The overall success rate of needling or bleb revision was 96% after an average follow-up of 20 months. Thus, encapsulation of the filtering bleb, although requiring additional surgery in many cases, carries a favorable long-term prognosis.