Choudhary S, Kaur M, Pandav SS, Kaushik S. Post-trabeculectomy early bleb localization mimicking a '
ring of steel'.
J Postgrad Med 2022;
68:100-101. [PMID:
35322658 PMCID:
PMC9196295 DOI:
10.4103/jpgm.jpgm_738_21]
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Abstract
A 54-year-old-man underwent trabeculectomy with mitomycin-C (0.02%). At 4-week follow-up, there was an elevated, well-circumscribed bleb with raised intra-ocular pressure (IOP) of 32-mmHg, with a classic “ring of steel” appearance, typically seen in a tenon's cyst. A sub-tenon needle revision re-established aqueous flow. Two weeks later, the IOP was 8-mmHg without any anti-glaucoma medications. A diffuse well formed bleb was noted. Careful ocular examination helps to identify early post-operative localized bleb that may appear like a “ring of steel” but can be managed by needling, unlike a tenon's cyst, which would require more extensive intervention.
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