Question 1

What does the procedure involve?

Accepted Answer

Bleb needling is usually done under local anaesthetic in the outpatient clinic. Drops are used to numb the front surface of the eye, followed by an injection in the skin around the eye that makes the area numb for a few hours and may temporarily affect your vision. A fine needle is used to break down the scar tissue wall of the bleb to improve drainage of the aqueous humour. An anti-scarring drug is then injected to help prevent further scarring. At the end, an antibiotic and steroid injection may be given to reduce the risk of infection and inflammation.

Question 2

Are there any risks or side effects?

Accepted Answer

The most serious risks are bleeding inside the eye or a serious infection; antibiotic drops are given to help prevent infection. These complications are rare, occurring in less than 1 in 1000 cases. The pressure in the eye may rarely become too low after the procedure and need further intervention. The anti-scarring agent can sometimes cause the wound to leak or temporarily affect the surface of the cornea, which usually recovers. Some slight discomfort after the needling is common and can be relieved with Paracetamol. These risks are the same as those present with the original trabeculectomy drainage operation.

Question 3

What is the success of bleb needling?

Accepted Answer

Bleb needling works in more than half of the eyes treated to restore and improve drainage. It is most successful when the trabeculectomy operation has been performed relatively recently.

Question 4

Why might I need bleb needling?

Accepted Answer

You may need bleb needling if your trabeculectomy drainage surgery has not lowered the eye pressure enough, or if the drainage bleb has scarred down and stopped working. Scarring can occur shortly after the operation or at any time later. Restoring drainage helps to protect the optic nerve from further glaucoma damage.

Are there any risks or side effects?

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