TAG Episode 19 - Bleb Needling: Slit Lamp Revision (mp3)

In this episode, Dr Solish and I discuss the art of “needling” a filtering bleb, or as he likes to call it, a Slit Lamp Revision (SLR), to resuscitate its function. Beginning with the history of when he first thought of the idea as a resident and it was shot down and how this evolved to using antimetabolites in conjunction with the needling in order to discourage fibroblasts from forming more scar tissue from the procedure. You might be surprised to learn what types of blebs are more likely to improve with Slit Lamp Revision! (See the enhanced version of this podcast for chapter markers and images.)

Dr Solish’s contact information:
Unit 230
630 S Raymond Ave
Pasadena, CA 91105-3283
Ph: (626) 577-1115

This episode was recorded live in March 2011 during the American Glaucoma Society annual meeting using a Shure SM58 microphone with a Marantz PMD661 digital recorder. Mixing and sound levelling were completed in February 2012 on a MacPro, MacBook Pro and MacBook Air using Levelator, Fission, and Garage Band. Narration was overdubbed using a Heil PR40 Microphone.

Opinions expressed in this podcast  are those of the speakers and are not intended to be taken as the standard of care for glaucoma treatment. Please always weigh the complete clinical picture and involve patients with any decisions in their care.

Selected references:
Solish, A., Solish, S. Treatment of leaking filtration blebs using mitomycin C. J. Glaucoma, 8:1 supp. 1999.

Solish, A. Treatment of leaking filtration blebs with bleb extension utilizing mitomycin C. 6th Congress of the European Glaucoma Society London, UK, Discussed poster June 12, 2000.

Solish, A. Clinical Experimental Evidence for a New Theory of Leaking Filtration Blebs UCLA Jules Stein Eye Institute Research and Alumnit Conference June 2, 2001

Solish, A. Treatment of leaking filtration blebs with bleb expansion utilizing mitomycin C. PAAO Buenos Aires, July 24, 2001

Solish, A. Treatment of leaking filtration blebs with bleb expansion utilizing mitomycin C .AGS  San Juan Puerto Rico February 28 2002

Solish, A. “Treatment of leaking filtration blebs with bleb expansion utilizing mitomycin C”. May 2002

Solish, A “Is mitomycin really the cause of leaking filtration blebs? “AAO meeting Chicago October 15, 2005


Robert M Schertzer, MD, MEd, FRCSC
Clinical Associate Professor
Dept of Ophthalmology & Visual Sciences
University of British Columbia

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