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Abstract #8595 Published in IGR 5-1
Needle revision of failed filtering blebs augmented with subconjunctival injection of mitomycin C
Ben Simon GJ; Glovinsky YOphthalmic Surgery Lasers and Imaging 2003; 34: 94-99
OBJECTIVE: To evaluate the short-term efficacy and safety of needle revision of failed filtering blebs augmented with subconjunctival injection of mitomycin C. PATIENTS AND METHODS: Needle revision of failed filtering blebs followed by subconjunctival injection of 10-20 μg of mitomycin C was performed in 41 eyes. Short-term results were analyzed six months postoperatively. RESULTS: The mean (± standard deviation (SD)) intraocular pressure (IOP) decreased from 26.4 ± 6.2 to 16.4 ± 6.5 mmHg (p < 0.001), and the mean (± SD) number of medications decreased from 2.8 ± 1.4 to 0.7 ± 1.1 (p < 0.001). The overall success rate (defined as IOP between 5 and 21 mmHg and no serious complications) was 76%. Initial IOP, number of previous surgical procedures, type of glaucoma, and lens status did not influence the success rate. The resulting bleb was significantly larger in the successful cases (2 ± 0.8 versus 0.33 ± 0.5; p < 0.001). Complications included one case of late suprachoroidal hemorrhage. The mean (± SD) visual acuity remained stable (delta visual acuity in Snellen lines = 0.023 ± 1.1). CONCLUSIONS: Needle revision followed by subconjunctival injection of mitomycin C is an alternative to more complicated surgical procedures in cases of failed filtering blebs. Bleb formation was essential for successful reduction of IOP, which suggests subconjunctival injection of mitomycin C by itself may not lower IOP.
Dr. G.J. Ben Simon, Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel
Classification:
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
