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Abstract #10004 Published in IGR 5-3
Needling revision of failed filtering blebs after trabeculectomy: a retrospective study
Fagerli M; Løfors KT; Elsås TActa Ophthalmologica Scandinavica 2003; 81: 577-582
PURPOSE: To determine the efficacy and safety of needling revision of failed filtering blebs. METHODS: The authors reviewed retrospectively 26 eyes that had undergone needling revision for failed trabeculectomy. The needling revisions were performed either with adjunctive use of mitomycin C, 5-fluorouracil or without antimetabolites. The procedure was usually performed as a clinic procedure, using a 27-gauge needle. RESULTS: The mean follow-up time was 14.5 ± 11.3 months (range, 6.0-48.0 months). Intraocular pressure (IOP) decreased from 28.8 ± 6.8 mmHg (range, 19.0-40.0 mmHg) to 15.3 ± 5.2 mmHg (range, 7.0-35.0 mmHg). Twelve eyes (46.2%) achieved success, defined as IOP 18 mmHg without medication; 11 eyes (42.3%) achieved qualified success, defined as IOP 18 mmHg with antiglaucomatous medication, and three of 26 eyes (11.5%) were classified as failures. The success rate after the initial needling was 64% at six months and the same after one and two years. The success rate after one or more needlings was 96% at six months and 77% at one and two years. Complications developed in six of the 26 eyes (23.1%). These involved transient corneal epithelial defects in three eyes (11.5%), temporary conjunctival wound leak in two eyes (7.7%), and development of bullous keratopathy in one high risk eye (3.8%). CONCLUSIONS: These results are comparable to the results of other studies. Needling revision appears to be a useful tool in the management of glaucoma.
Dr. M. Fagerli, Department of Ophthalmology, St. Olav University Hospital, N-7006 Trondheim, Norway. marit.fagerli@stolav.no
Classification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
