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The Grover spatula is used ab-interno to reach the trabeculectomy ostium to break adhesions to re-stablish bleb flow and reach the subconjunctival space. A 27 gauge needle is used ab-externo to enter the same space, and friction between the two instrument’s tips are used to lyse any stubborn adhesions. Mitomycin C is injected in the exact location of the filtering bleb using the same needle.
