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Surgical Technique for Excisional Bleb Revision Using a Rotational Conjunctival Flap for a Large Conjunctival Defect

Bleb dysesthesia is a common but under recognized late complication of trabeculectomy, sometimes requiring surgical revision if conservative measures fail. We describe in detail a surgical technique for closure of a large conjunctival defect following bleb excision for refractory dysesthesia. Two subconjunctival 5-fluorouracil injections were given to improve bleb function. Eight months post-operatively, the intraocular pressure is well controlled on two agents, and the patient has had resolution of dysesthesia.