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Abstract #46815 Published in IGR 13-3
Posterior revision for failed blebs: Long-term outcomes
Coote MA; Gupta V; Vasudevan S; Crowston JGJournal of Glaucoma 2011; 20: 377-382
AIM: To report the long-term efficacy and safety of same site revision trabeculectomy with mitomycin application via a posterior approach. Methods: A noncomparative retrospective case series of consecutive revision trabeculectomies performed for inadequate bleb function between March 2003 and March 2007 by a single surgeon. Surgery involved a posterior/fornix incision with opening of the scleral flap posteriorly at the same site as previous surgery and application of 0.2 to 0.4 mg/mL mitomycin. Results: Fifty-seven eyes were followed for an average of 33(plus or minus)15 months. Mean baseline intraocular pressure (IOP) reduced from 21.5(plus or minus)6.5 to 11.2(plus or minus)4.4 and 8(plus or minus)3.6 mm Hg at 1 and 5 years, respectively (P<0.001). On Kaplan-Meier survival analysis the probability of maintaining IOP (less-than or equal to)15 mm Hg without medication at the end of 1 year was 95% (n=57) and at 3 (n=36) and 5 years (n=7) was 84%. Eighty-five percent of patients were on no antiglaucoma drops at last follow-up. Four cases required a second procedure (7%), transient choroidal effusions occurred in 4 eyes (7%), corneal decompensation in 1 eye (1.7%), and ptosis in 1 (1.7%). Conclusions: Posterior approach to surgical revision of failed filtration surgery is an effective procedure with good long-term control of IOP.
M.A. Coote. Centre for Eye Research Australia, University of Melbourne, 32 Gisborne Street, East Melbourne, VIC 3002, Australia.
Classification:
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
