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Patients need to be seen frequently to determine when there is excessive scarring and if they will need steroids or anti- metabolite injections. She prefers to see patients once a week postop- eratively to appropriately recognize scarring, wound leak, and hypotony. In the early postoperative period, the bleb should ideally be low and diffuse—try to avoid focal, avascular blebs with a ring of steel. "This is the type of bleb mor- phology that is very high risk for late leak and failure," she said. If corkscrew vessels are present, be proactive—the patient will need antimetabolite injections weekly to prevent a rise in IOP. Overall, surgeons should have a keen awareness of when to inter- vene and when not to. Over time, surgeons will learn when it is ap- propriate to take the patient back to surgery if there is excessive scarring or complications—and when to sit back and let the body heal on its own, she said. EW Editors' note: Dr. Green has no finan- cial interests related to her comments. Contact information Green: seagreen@bigpond.com when handling the conjunctiva and create an appropriately sized wound—it should be large enough to get adequate exposure but not so large that it makes closure difficult. When it comes to antimetabolites, she recommends using 0.2 mg/mL of mitomycin-C for 3 minutes, and 0.4 mg/mL for high-risk cases. When closing, Dr. Green prefers to use releasable flap sutures rather than fixed. "The reason for this is I don't have easy access to an argon laser, and often in the postoperative period patients can be very tender, and the sutures can be obscured by blood," she said. Conjunctival closure is arguably the most important surgical step, she said. "Spending 5 minutes extra here is time well spent because it is so painful coming back later and having to put in sutures in conjunc- tiva that's been bathed in aqueous and doesn't behave well." Surgery is only the beginning "I always tell my residents that the operation is only half of the suc- cess," Dr. Green said. "You need to do a good operation, but the postoperative management is what determines the success of your surgery." Jen Call (844) 266-2747 to find out how to bring OASIS ® to your patients. © 2014 OASIS Medical, Inc. OASIS, Oasis TEARS and Oasis LID & LASH names and logos are registered trademarks of OASIS Medical, Inc. 514 S. Vermont Ave, Glendora, CA 91741. www.oasismedical.com Diabetes Menopausal Side effect from prescription Natural aging Wears contacts Post-surgical Daily computer use Taking antihistamines RA Your Patient Your patients will spread the word. To Your Dry Eye Clinic. BRING Oasis TEARS ® and Oasis LID & LASH ® Gel Cleanser are offered through physicians' practices to support patient care and the growth of their business. Glaucoma surgery in Oz: Tips from down under Catherine Green, MBChB, FRANZCO, MMedSc, discusses useful tips to improve the success of glaucoma surgery from her practice in Australia. She gives pearls for reducing intraoperative and postoperative complications. Watch this video and more on the EyeWorld Video Reporter from the Women in Ophthalmology 2014 Summer Symposium at EWrePlay.org.