Late-onset bleb leakage.

CASE REPORT A 75-year-old man presents for routine follow-up examination 6 years after uncomplicated primary trabeculectomy with a 2minute intraoperative application of mitomycin C (MMC, 0.4mm/ mL). Although progression had occurred when the intraocular pressure (IOP) was in the mid teens, the visual fields have remained stable since filtration surgery was performed. The IOP is 8mm Hg and a large, thin-walled avascular filtration bleb is present at the superior limbus. A conjunctival epithelial hole is visible in the center of the bleb overlying the scleral flap and leakage is noted when fluorescein is applied (positive Seidel test). No infiltrate is observed within the bleb, and there is no evidence of intraocular inflammation, choroidal effusion, or chorioretinal folds in the macula. The visual acuity is 20/40 due to an early nuclear cataract.