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Abstract #54556 Published in IGR 15-3
Combined ab externo and ab interno revision of failed filtering blebs with adjunctive mitomycin C
Magacho L; Shetty RKEuropean Journal of Ophthalmology 2014; 24: 196-201
PURPOSE: To report the results of combined ab externo and ab interno revision with mitomycin C (MMC) of failed filtering blebs in glaucoma patients.METHODS: Glaucoma patients with a failed trabeculectomy who had undergone internal and external revision with MMC in the last 6 years with at least 12 months of follow-up were considered. All study patients followed the same protocol in the operating room: injection of 0.2 mL of MMC (0.4 mg/mL) 2 cm lateral from the bleb followed by internal revision with an iris spatula and external revision with a 26-G × ½" needle. Success was defined as an intraocular pressure (IOP) ≥6 mm Hg and ≤18 mm Hg with (qualified) or without (absolute) any ocular hypotensive drugs. RESULTS: The study included 25 eyes of 22 glaucoma patients. Mean age was 65.2 ± 10.5 years. Mean follow-up was 26.9 ± 10.3 months. The IOP was reduced from 24.5 ± 6.0 mm Hg preoperatively to 10.0 ± 3.3 mm Hg at the last visit (p<0.001). The number of ocular hypotensive medications was reduced from 1.8 ± 1.0 to 0.2 ± 0.6 (p<0.001). There was no change in visual acuity (0.83 ± 0.75 vs 0.83 ± 0.74, p = 0.7). Three patients developed choroidal detachment, another eye had a transient hypotony with maculopathy, and 2 patients developed cataract. Absolute success was achieved in 80% of eyes, and qualified success in 16% of eyes CONCLUSIONS: Combined ab externo and ab interno revision with MMC can be an effective technique to revitalize failed filtering blebs in glaucoma patients with minimal complications.
1 Ophthalmology Department, Hospital VER-Excellence in Ophthalmology, Federal University of Goiás, CEROF-UFG, Goiânia - Brazil.
Full articleClassification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
