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Abstract #8680 Published in IGR 5-1
Transconjunctival mitomycin-C in needle revisions of failing filtering blebs
Iwach AG; Delgado MF; Novack GD; Nguyen N; Wong PCOphthalmology 2003; 110: 734-742
PURPOSE: To report the efficacy and safety of transconjunctival mitomycin-C as an adjunct to needle revision of failing filtering blebs. DESIGN: Retrospective, consecutive, noncomparative interventional case series. PARTICIPANTS: Forty-one patients (42 eyes) undergoing bleb revisions by a single surgeon at a single institution from May 1997 to January 2001. METHODS: The authors retrospectively reviewed charts of 42 eyes that underwent needle revision of the failing filtering bleb using transconjunctival application of mitomycin-C. Needling of the bleb was performed with a 25-gauge needle. The site of the needle puncture was sutured and followed by application of transconjunctival mitomycin-C (0.5 mg/ml) by means of a sponge left in contact with the conjunctival epithelium for 6 minutes. A group of patients received additional subconjunctival injections of 5-fluorouracil in the postoperative period. Success was defined as a reduction in intraocular pressure (IOP) of 30% without the use of antiglaucoma medications and no further surgical procedures to control IOP. MAIN OUTCOME MEASURES: IOP, visual acuity, complications, number of glaucoma medications used at the final visit. RESULTS: Mean preoperative IOP was 22.1 ± 8.0 mmHg, which was reduced by 9.6 ± 7.9 mmHg to a mean postoperative IOP of 12.5 ± 6.1 mmHg. Mean follow-up was 17.6 ± 13.5 months. Kaplan-Meier survival analysis showed a probability of continued success at 12 months of 76.1%, and at 24 months of 71.6%. The most common complication was hyphema in 7.1% of patients. Twenty-six eyes also received postoperative injections of 5-fluorouracil. CONCLUSIONS: Transconjunctival mitomycin-C may enhance the success of the needling procedure in failing filtering blebs.
Dr. A.G. Iwach, 490 Post Street, Suite 644, San Francisco, CA 94102, USA
Classification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
