Collagen crosslinking-assisted treatment of a bleb leak: Enhancement of vascularization around the bleb

Aim and objective: To present a case with bleb leakage treated with collagen crosslinking (CXL). Background: Bleb-related complications can cause serious problems even a long time after trabeculectomy. In this case report, we present a relatively unknown treatment method for bleb leakage which might be one of the long-term complications of trabeculectomy. Case description: A 60-year-old male patient was admitted to our clinic with a decrease in his left vision. The patient had a history of left trabeculectomy. The bleb leakage was observed. Autologous blood was injected into the bleb area as the first line of treatment. Collagen crosslinking was applied to the bleb area upon the recurrence of the leakage. In the 1st week after the CXL, CXL was repeated in the bleb area upon the observation that the leakage recurred. It was observed that the leakage did not recur and bleb vascularization was triggered after CXL. Conclusion: Conjunctival CXL might be a non-invasive, viable method in the management of bleb leakage. It might be applied in conjunction with bandage contact lenses for the treatment of late bleb leaks as an alternative treatment method before going into surgical intervention. Clinical significance: As a result of conjunctival CXL application, collagen permeability reduction and neovascularization secondary to CXL application might be effective in preventing bleb leakage. However, further studies are needed to prove this.