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Transconjunctival suturing sclera

This patient underwent a trabeculectomy with mitomcyin then later developed hypotony and a cataract. They were referred back to have the cataract removed and to do something about the low eye pressure that was progressing to the point of leaving folds in her choroid. I performed cataract surgery and then placed a suture through the scleral flap right through the conjunctiva. This suture will works its way through the bleb and end up buried under the conjunctiva as long as the tissue is not so avascular as to never heal properly.