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Jeffrey Freedman, MD, PhD, presents a patient who is an African-American who had failed previous implant surgery due to bleb fibrosis. Supra-Tenon implantation was chosen to avoid the effect of Tenons capsule which contains the mRNA for the pro-fibrotic cytokine transforming growth factor beta. The patient had successful outcome with thin bleb and adequate pressure control. Supra-Tenon surgery is chosen where previous glaucoma surgery has failed due to bleb fibrosis.