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Abstract #5742 Published in IGR 2-1
Needling with intra-bleb 5-fluorouracil for intractable neovascular glaucoma
Ophir A; Porges YOphthalmic Surgery and Lasers 2000; 31:38-42
BACKGROUND AND OBJECTIVES: Trabeculectomy for neovascular glaucoma (NVG) often results in filtering bleb scarring. The outcome of a needling procedure with intra-bleb 5-fluorouracil (5-FU) administration in NVG eyes is presented. PATIENTS AND METHODS: Following trabeculectomy with mitomycin C (MMC), intraocular pressures (IOPs) ranged between 36 and 56 mmHg in three painful, neovascular glaucomatous eyes, despite treatment. Each eye was then injected subconjunctivally with 1.0 mg 5-FU, adjacent to and within the filtering bleb. The needle was advanced and penetration into the anterior chamber through the bled, anterior to the scleral flap, followed. RESULTS: In each eye, the IOP dropped immediately. After 18-29 months, IOPs were 11-22 mmHg; in two eyes, without hypotensive medications. Cataract progression was evident in the two eyes that had had cataracts preoperatively. CONCLUSIONS: The postoperative needling, in conjunction with the dual effect of intraoperative MMC and intra-bleb 5-FU, was found efficacious and saved further surgery in these intractable cases.
Dr. A. Ophir, Ophthalmology Hillel-Yaffe Medical Center, Hadera, Israel
Classification:
9.4.5.1 Neovascular glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous)
