May be associated with progressive conjunctival hyperemia.
Signs:
Tense, elevated, smooth dome with a thick wall aqueous-filled cyst
Absence of conjunctival microcysts
Usually appears during the first postoperative month
Complications associated with encapsulated filtration blebs include elevated intraocular pressure, corneal dellen, and ocular discomfort.
Management
Resumption of glaucoma medications (aqueous suppressants) to lower the IOP and to allow the remodeling of the cyst wall. The encapsulation gradually resolves after a period of 2-4 months.
Digital pressure and steroid therapy may be useful to reverse the encapsulation response and improve bleb function.
If medical therapy is insufficient to control IOP, a surgical approach (e.g. bleb needling, surgical revision) should be considered.
Repeated bleb needling at the slit-lamp can effectively puncture the fibrous tissue and encourage filtration.
When bleb needling is unsuccessful, a more invasive technique such as surgical excision of the fibrous capsule may be necessary