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OBJECTIVE: To investigate the efficacy of needle revision with 5-fluorouracil (5-FU) on the dysfunctional filtration blebs after trabeculectomies and to assess the factors that may impact the success. METHODS: Fourty eyes of 34 patients underwent the needle revision of the malfunctional blebs with 5-FU at clinic visits in 2 - 8 weeks immediately after trabeculectomies and were followed up for 12 weeks. RESULTS: After revision through needling procedures, the blebs were diffused and elevated in 26 eyes, thinned and multicysted in 9 eyes, thickened and focalized or invisible in profile in 5 eyes. Intraocular pressures (IOPs) were significantly (P < 0.01) lowered from (23.6 ± 2.1) mmHg (1 mmHg = 0.133 kPa) of pre-needling to (16.3 ± 2.9) mmHg of post-needling in 35 functional filtering blebs. The Kaplan-Meier survival curve for the 40 eyes showed a success rate of (87.51 ± 5.23)% within the follow-up time. Logistic regression did not show significant difference in needle revision among the types of glaucoma, the history of intraocular surgery, and the ages of patients. However, poorer responses were observed following greater intervals of needling operation from previous trabeculectomy (P = 0.046). The time interval for the median efficacy level is 5.9 weeks. Subconjunctival hemorrhage occurred in 6 eyes during the needle revision, and no other post-needling complications were found during the follow-up time. CONCLUSIONS: The needle revision combined with 5-FU is an effective, safe, and simple method of improving early dysfunctional filtration blebs after trabeculectomies. The success rate of needle revision was about 50% at 6 weeks and the delay of needle revision may result in poor responses. LA: Chinese
Dr. Z.Q. Ren, Department of Ophthalmology, Peking University Fist Hospital, Beijing 100034, China. renzeqin@163.com
12.8.11 Complications, endophthalmitis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)