Dr. Razeghinejad revises a trabeculectomy bleb that is overhanging the cornea. If the overhanging portion is excised and the residual bleb is Seidel negative, then the procedure is finished. If the residual bleb leaks, then it must be revised by lysing subconjunctival scar tissue, opening the sclerostomy flap, placing new sutures, checking filtration flow, then closing healthy conjunctiva over the flap to form a new bleb.

Dr. Razeghinejad performs an ab externo bleb revision for an avascular, Seidel-positive bleb. Subconjunctival anesthesia is injected. The avascular bleb is excised, then the adjacent healthy conjunctiva is mobilized and approximated to the limbus to form the new bleb. The conjunctiva is closed with running Vicryl sutures along the sides and mattress sutures along the limbal edge.