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Abstract #48757 Published in IGR 14-1
Bleb needling with subconjunctival injection of sodium hyaluronate 1.4%: 1-year outcomes
Shafi F; Agrawal P; Holder R; Sung VCanadian Journal of Ophthalmology 2011; 46: 537-542
OBJECTIVES: To assess the safety and efficacy of 5-fluorouracil (5-FU)-augmented bleb needling revision (BNR) with subconjunctival Healon GV (sodium hyaluronate 1.4%) over a 12-month follow-up. DESIGN: Retrospective consecutive case series. PARTICIPANTS: We studied 54 patients who had undergone primary BNR with adjunctive 5-FU and routine subconjunctival Healon GV between 2004 and 2007. METHODS: BNR was performed using multiple puncturing motions through the bleb: a 0.4 mL Healon GV injection between the bleb and conjunctiva; and a 5-FU (10 mg in 0.4 mL) injection into the substance of Healon GV. Success was defined as follows: (1) complete success, indicating intraocular pressure (IOP) reduction ≥ 20% and to ≤ 21 mm Hg but > 5 mm Hg without antiglaucoma medication; or (2) qualified success, indicating IOP reduction ≥ 20% and to ≤ 21 mm Hg but > 5 mm Hg with or without antiglaucoma medication. Patients requiring additional filtration surgery during the 12-month follow-up period were considered failures. RESULTS: Data collection was completed for 53 eyes of 46 patients. The IOP fell from a preoperative mean of 22.7 ± 7.95 mm Hg to 16.3 ± 4.34 mm Hg at 12 months (p < 0.001). The complete success rate was 26.4%; the qualified success rate was 43.4%. Of the eyes studied, 28 (52.8%) achieved IOPs of ≤ 16 mm Hg at 12 months. Complications occurred in 16 eyes (30%), and 3 required surgical intervention. CONCLUSIONS: Subconjunctival Healon GV in 5-FU-augmented bleb needling revision is a relatively safe and effective technique for reducing IOP in the short to medium term, and it involves few significant complications.
Birmingham and Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK.
Full articleClassification:
12.8.1 Without tube implant (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)