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Abstract #22643 Published in IGR 11-1
The efficacy of 5-fluorouracil bleb needling performed 1 year or more posttrabeculectomy: a retrospective study
Kapasi MS; Birt CMJournal of Glaucoma 2009; 18: 144-148
PURPOSE: To determine the efficacy of a subconjunctival needling revision using 5-fluorouracil (5FU) when administered to patients who have nonfiltering, flat, or encapsulated blebs over 1 year after the original surgery. METHODS: The charts of 37 glaucoma patients, who had undergone both a trabeculectomy filtering procedure and a subconjunctival 5FU needling revision, with a minimum interval of 1 year between these procedures and with no intervening surgical procedures, were retrospectively reviewed. The needling was a clinic procedure using a 30-gauge needle and 0.1 mL of 50 mg/mL 5FU. RESULTS: Intraocular pressure (IOP) decreased by an average of 10.5 mmHg (44.8%) immediately after the needling procedure. Eleven eyes (29.7%) achieved absolute success, defined as IOP control with no further needling revision, surgical intervention, or antiglaucoma medication in the 2-year follow-up period. Thirteen eyes (35.1%) achieved a qualified success, defined as IOP control with resumed medication use, undergoing a laser procedure, or a repeat needling within the follow-up period. Thirteen eyes (35.1%) failed the procedure by requiring a repeat surgical intervention. The mean IOP was 16.3±4.6 mmHg in the success group, 15.5±6.5 mmHg in the qualified success group, and 27.7±8.9 mmHg in the failure group at the end of follow-up. CONCLUSIONS: Late 5FU needling is an effective method to control IOP and avoid further surgery in a high proportion of patients with medically uncontrolled nonfiltering blebs.
Dr. M.S. Kapasi, Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
Classification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)