advertisement
Abstract #6932 Published in IGR 4-1
Needling revision with subconjunctival 5-fluorouracil in failing filtering blebs
Chang SHL; Hou CHChinese Journal of Ophthalmology 2002; 25: 97-103
BACKGROUND: 5-Fluorouracil, an antimetabolic agent, improves the success rate of trabeculectomies by inhibiting subconjunctival fibrosis. However, complications may be associated with early postoperative use. The authors investigated the outcome of needling revision with delayed subconjunctival 5-fluorouracil in failing filtering blebs after a trabeculectomy in patients with medically poorly controlled glaucoma. METHODS: The authors performed needling revision with subconjunctival 5-fluorouracil injection 5.0 ± 4.0 weeks after trabeculectomy with failing filtering blebs in 25 eyes of 24 patients. The diagnoses of these patients were primary angle-closure glaucoma (four cases), primary open-angle glaucoma (four cases), post-cornea-graft glaucoma (eight cases), traumatic glaucoma (five cases), neovascular glaucoma (three cases), and pseudophakic glaucoma (one case). RESULTS: Total success was achieved in 21 eyes (84%), including complete success in ten (40%) and qualified success in 11 (44%) after 3.2 ± 1.2 needling revisions over an average 8.3 ± 7.0-month follow-up period from the last needling revision. The mean intraocular pressure was 16.0 ± 8.4 mmHg in the last visit compared with 26.0 ± 8.1 mmHg before the procedure. Major complications were transient hypotony (one case), transient corneal epithelial defect (13 cases), and hyphema (three cases). CONCLUSIONS: This study supports the efficacy and safety of the delayed use of 5-fluorouracil with needling revision for managing failing filtering blebs following a trabeculectomy.
Dr. S.H.L. Chang, Department of Ophthalmology, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC. hlchang@cgmh.org.tw
Classification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
