We read with great interest the article by Biswas et al on the use of compression sutures with autologous blood injection for leaking trabeculectomy blebs. We have used intrableb autologous blood injection at the slit lamp as initial management in early and late persistent bleb leaks. In a retrospective study in our unit, four of five persistent leaks were successfully sealed with intrableb autologous blood injection alone. All five eyes had antimetabolites during the original trabeculectomy. Three required two repeat injections, with only one of five requiring surgical revision of the bleb. With a mean follow-up of 3.3 years (0.75 months to 6 years), all four patients maintained an intraocular pressure less than 21 mm Hg, without topical medication and no further leaks.
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