Perform aqueous and vitreous taps in case of infection. Thin blebs, especially after antimetabolites, are at risk for late leaks. However, leaks can recur and the filtration effect can be lost with subsequent IOP rise. Infection Early infection develops within the first week following surgery. Early infection is caused by the introduction of the infective agent at the time of the procedure, not specifically related to bleb complications.
Late infection occurs weeks to months after surgery.
Late infections probably are due to transconjunctival migration of microorganisms through leaks, holes, breaks, or weakened thin tissue. Thin blebs after the use of antimetabolites are a definite risk factor for late infections. Once the bleb starts to extend downwards from the superior quadrants, its expansion downwards is favored by the relative thinness of the Tenon layer laterally. When bulging, these blebs can cause symptoms as they interfere with blinking and tear flow. Management can include lubricants and tear supplements, as well as staged removal of sectors of conjunctiva, away from the functioning upper quadrant.