Overdrainage after trabeculectomy can result in vision loss from hypotony maculopathy.  This lecture addresses the various approaches to this complication with a case requiring repair of the avascular bleb, resuturing of the scleral flap with releasable sutures, tamponading with a full thickness scleral patch graft, adjus ting the flow with 3 overlay 10/0 nylon sutures and watertight closure of the conjunctival wound.  The key is the ability to adjust the intraocular pressure post-repair for optimal control.