Reconstruction of a Leaking Filtering Bleb after Trabeculectomy Using Amniotic Membrane Transplantation and Contralateral Conjunctival Autograft: A Case Report

Abstract Purpose: To describe the successful reconstruction of a leaking filtering bleb with necrotic conjunctiva long after trabeculectomy, using a double-layer amniotic membrane transplantation (AMT) combined with a contralateral conjunctival autograft. Methods: A 63-year-old woman developed a thin, avascular, leaking bleb ten years after trabeculectomy with mitomycin-C. After infection control with fortified antibiotics, reconstruction was performed using AMT over the scleral flap, a contralateral conjunctival–Tenon autograft, and an additional AM patch. Results: The ocular surface healed uneventfully. At two months, the bleb was sealed with good filtration and stable intraocular pressure. Best-corrected visual acuity improved to 0.2 logMAR. Conclusion: The combined use of amniotic membrane and contralateral conjunctival autograft offers an effective solution for late-onset bleb leaks when local conjunctiva is friable.