Purpose: To describe two cases in which the lacrimal gland was considered t
o extend downward under the bulbar conjuctiva following trabeculectomy.
Patients and Methods: We report two patients who complained of epiphora. af
ter trabeculectomy. A biopsy was performed on the tissue under the bulbar c
onjunctiva on the periphery of the bleb of case 1. The anatomical relations
hip between the holes and the avascular filtering bleb in case 2 was invest
igated using ultrasound biomicroscopy.
Results: In case 1, a biopsy showed the lacrimal gland tissue filtrated wit
h mononuclear cells. In case 2, ultrasound biomicroscopy revealed no connec
tion between the multiple leaking holes and localized filtering bleb.
Conclusion: Following trabeculectomy at the superior temporal quadrant, we
should consider downward extension of the lacrimal gland as a possible sour
ce of a patient's complaint of epiphora.