LD - 74 yo woman Bleb revision Left eye for hypotony - March 2014 Conjunctiva incised 1 mm posterior to avascular bleb Mobilized conjunctiva posteriorly + anteriorly into bleb Free floating open scleral flap found Inserted scleral strip with tapered anterior edge into sclerectomy Secured with two 10-0 nylon sutures Scleral patch placed over this Secured with two 10-0 Nylon diagonal transconjunctival limbal sutures Anterior edge supported by old bleb tissue limbal edge Sutured double layer of amniotic membrane over sclera Closed conjunctival incision with 8-0 vicryl BV-130-4, incorporating amniotic membrane

LD - 74 yo woman Bleb revision Left eye March 2014 POD #1 Left eye VA 20/50, IOP 28 Started Timolol + Topical Pred 6x/d, tapered over 4 months Photo at 6 months postop

LD - 74 yo woman Bleb revision Left eye March 2014 Last seen May 2015 (pre and postop OCT below) BCVA Left eye 20/40 (plano) (Left eye preop VA 20/150 with striae) IOP Left eye = 18 (Pach R 560, L 580) (preop IOP Left eye = 1) Latanoprost OU HS, Dorzol-Timolol OS BID, Pilo 1% OS QID

VJ - 46 yo woman June Superotemporal Trabeculectomy + MMC 0.4 mg/cc + 4 min Tapered topical steroid over 4 months IOP next 2 years 5-8 mm Hg left eye Mid 2009 – IOP Left eye plummeted to 0-2 mm Hg – VA remained 20/50 – 20/70 next 3 years Left eye VA declined to 20/200 Declined intervention – family health issues

VJ - 46 yo woman December 2014 Bleb revision left eye Incised 2 mm posterior to avascular edge of bleb Mobilized conjunctiva posteriorly and dissected anteriorly into bleb Scleral flap had melted away leaving only bed Scleral patch placed over previous trabeculectomy site (did not use scleral strip) Secured with two 10-0 Nylon diagonal transconjunctival limbal sutures Anterior edge supported by old bleb tissue limbal edge Added 4 more transconjunctival sutures lateral edges of graft Single mattress through anterior edge of graft and cornea Closed conjunctival edges with running 8-0 vicryl BV-130-4

VJ - 46 yo woman December 2014 Bleb revision left eye POD #1 – Left eye VA 20/150, IOP 2 mmHg – Rx only NeoPolyDex ointment BID for 2 weeks Initial 2 months postop single digit IOP May 2015 – BCVA Right 20/30, Left 20/50 – IOP Right 13, Left 13 mmHg – No glaucoma meds Photos 6 months postop

AM - 41 yo woman High myope CL wearer Axl Right 30.7 mm, Left 28.7 mm IOP OD became elevated to 20s on max meds, Progressive VF loss Pach Right 615, Left 616 (VF below is from 2007) June 2007 – Right Trabeculectomy + MMC 0.2 mg/cc + 2 min Oct 2007 – Left Trabeculectomy + MMC 0.2 mg/cc + 2 min

AM - 41 yo woman March 2013 – Progressive cataract - Phaco + PCIOL right eye February 2014 Developed Bleb leak + blebitis right eye IOP right eye dropped to low single digits VA right eye dropped from 20/25 to 20/200 and had shallowing of AC Treated with topical antibiotics with resolution of blebitis but persistent bleb leak

AM - 41 yo woman February Bleb revision right eye Conjunctiva incised 1 mm posterior to avascular bleb Mobilized Conjunctiva posteriorly + anteriorly into bleb Scleral flap had disintegrated Inserted scleral strip tapered anteriorly into sclerectomy Secured with two 10-0 nylon sutures Scleral patch placed over this Secured with two 10-0 Nylon diagonal transconjunctival limbal sutures Anterior edge supported by old bleb tissue limbal edge Sutured layer of amniotic membrane over scleral patch Closed conjunctival incision with 8-0 vicryl BV incorporating amniotic membrane

AM - 41 yo woman February Bleb revision right eye May 2015 – VA Right 20/40, Left 20/40 – IOP 16 Right,6 Left, No bleb leak right eye – Dorzolamide-Timolol BID right eye Left eye has developed leak and scheduled for surgery