Effect of Needle Revision of Failed Filtering Blebs with Different Concentrations of Mitomycin C

Published on Jun 1, 2008in Journal of The Korean Ophthalmological Society
· DOI :10.3341/JKOS.2008.49.6.951
Kyeong Jin Woo3
Estimated H-index: 3
(CBNU: Chungbuk National University),
Sungmin Hyung4
Estimated H-index: 4
(CBNU: Chungbuk National University)
Sources
Abstract
Purpose: To investigate the efficacy and the risk factors for failure and complications of mitomycin C (MMC)-augmented needle revision (NR) of failed filtering blebs. Methods: Thirty eyes whose intraocular pressure (IOP) did not decrease after the cutting of scleral flap sutures were recruited. NR was performed with a 26-gauge needle under a slit-lamp. Immediately following NR, all eyes received a subconjunctival injection of 0.1 ml of 0.02 mg/ml (group A) or 0.1 mg/ml (group B) MMC at the adjacent conjunctiva. The mean follow-up period after the last needle revision was 13.2±4.2 months. Results: The mean IOP decreased from 25.7±10.6 mmHg before surgery to 13.7±2.5 mmHg at the last follow-up in group A and from 24.1±6.8 mmHg to 17.7±8.6 mmHg in group B (group A: p=0.001, group B: p=0.065). Subconjunctival hemorrhage, hyphema, and a shallow anterior chamber appeared in most cases. However, choridal detachment and avascular changes of the conjunctiva were observed in group B. Conclusions: IOP decreased in both groups A and B, but severe complications appeared only in group B. NR followed by a subconjunctival injection of 0.02 rather than 0.1 mg/ml is a safe and effective method. J Korean Ophthalmol Soc 49(6):951-957, 2008
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Purpose: To evaluate the effects of needle revision (NR) with and without mitomycin C (MMC) for failed filtering blebs after trabeculectomy, and to identify risk factors for failure. Methods: Thirty-one eyes whose intraocular pressure (IOP) did not decrease after cutting of scleral flap sutures were recruited. NR was performed with a 26-gauge needle under a slit-lamp. Immediately following NR, 15 eyes received subconjunctival injection of 0.002 mg (0.02 mg/ml) MMC at the adjacent conjunctiva. Re...
PURPOSE: To investigate the efficacy of bleb needle revision with high-dose mitomycin C in reviving failed filtering blebs after 1 year. PATIENTS AND METHODS: We reviewed the charts of 44 patients with one eye that had undergone bleb needle revision with a mixture of 0.1 mL of mitomycin (0.4 mg/mL) mixed with 0.1 mL of non-preserved 1% lidocaine. At least 12 months of follow-up were required. A successful bleb needle revision was defined as one that did not require a subsequent needling, glaucom...
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Purpose: To determine the success rate and complications of Mitomycin C (MMC) augmented needle revision on failed filtering blebs. Methods: We retrospectively investigated the records of 30 patients (32 eyes) who had undergone needle revision with MMC on failed filtering blebs. A mixture of 0.02 ml of MMC (0.4 mg/ml) and 0.02 ml of 2% lidocaine (20 mg/ml) was injected subconjunctivally. 5 minutes later, needle revision was done with bented 30 gauge needle. Results: The mean Intraocular pressure(...
Purpose : The purpose of the study is to determine the efficacy and safety of needle revision of failed filtering blebs using preoperative mitomycin C (MMC) application. Methods : We reviewed the records of 28 patients (31 eyes) who had undergone needle revision with MMC for the treatment of failed filtering bleb. MMC (0.02 mg/ml, 0.1 ml) was injected subconjunctivally one day before needle revision. Results : Postopertive mean follow-up period was 42 weeks. Twenty five eyes (80.6%) were classif...
Abstract PURPOSE: To investigate the association between control of intraocular pressure after surgical intervention for glaucoma and visual field deterioration. METHODS: In the Advanced Glaucoma Intervention Study, eyes were randomly assigned to one of two sequences of glaucoma surgery, one beginning with argon laser trabeculoplasty and the other trabeculectomy. In the present article we examine the relationship between intraocular pressure and progression of visual field damage over 6 or more ...
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#1Pierre G. Mardelli (UMKC: University of Missouri–Kansas City)H-Index: 2
#2Charles M. Lederer (UMKC: University of Missouri–Kansas City)H-Index: 3
Last. Khatab M. Hassanein (KU: University of Kansas)H-Index: 17
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Purpose: The purpose of the study is to determine the efficacy and safety of Mitomycin C (MMC) augmented slit-lamp needle revision of failed filtration surgery. Methods: The authors retrospectively reviewed the charts of 62 patients (62 eyes) (age, 72 ± 15 years) with failed filtration surgery who underwent needle revision using MMC. A mixture of 0.01 ml of MMC (0.4 mg/ml) and 0.02 ml of bupivacaine with epinephrine was injected subconjunctivally. Twenty to 30 minutes later, a 30-gauge needle wa...
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#1David S. Greenfield (UM: University of Miami)H-Index: 60
#2Michael P. Miller (UM: University of Miami)H-Index: 3
Last. Paul Palmberg (UM: University of Miami)H-Index: 33
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Purpose To report the incidence of failing filtration blebs after trabeculectomy with mitomycin C and to report the outcome of needling procedures for failing filtration blebs in these eyes. Methods We conducted a retrospective analysis of 537 eyes of 434 patients who had trabeculectomy with mitomycin C and reviewed the clinical course of 441 eyes of 338 patients with a minimum of three months of follow-up. Results In 441 eyes of 338 patients followed up for three months or more after trabeculec...
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#1Mark L. McDermottH-Index: 17
#2Jimin Wang (WSU: Wayne State University)H-Index: 1
Last. Dong H. Shin (WSU: Wayne State University)H-Index: 30
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Objective: To investigate the ultrastructural and physiologic effects of exposure of the human corneal endothelium to mitomycin at concentrations of 20 μg/mL and 200 μg/mL using electron microscopy and in vitro specular perfusion techniques. Methods: Four pairs of corneas (with one cornea of each pair receiving balanced salt solution [BSS Plus, Alcon Laboratories, Fort Worth, Tex] and the other receiving BSS Plus with 20 μg/mL of mitomycin) suitable for transplantation, except for extremes of ag...
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#1Theodore Krupin (NU: Northwestern University)H-Index: 44
#2Lisa F. Rosenberg (NU: Northwestern University)H-Index: 13
Last. Todd W. Perkins (UW: University of Wisconsin-Madison)H-Index: 11
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Purpose: The authors evaluate a long posterior tube shunt device with a pressure sensitive valve for filtration surgery in eyes with recalcitrant glaucoma. Methods: The device consisted of an anterior chamber tube connected to an oval (13 X 18 mm) episcleral explant. The explant was designed to maximize the area of surrounding encapsulation while still allowing implantation within one quadrant. A pressure-sensitive and unidirectional slit valve in the tube provided resistance to aqueous humor fl...
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#1Dong H. Shin (WSU: Wayne State University)H-Index: 30
#2Mark S JuzychH-Index: 23
Last. Kyle A. Parrow (WSU: Wayne State University)H-Index: 7
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We investigated the outcome of needling revision with adjunctive subconjunctival 5-fluorouracil (5-FU) performed on 30 eyes of 30 consecutive glaucoma patients with failed filtering blebs 49.0 ± 65.4 weeks after trabeculectomy. Follow up was 67.3 ± 22.8 weeks from the time of the first needling revision and 49.9 ± 26.2 weeks from the last needling procedure. Twenty-four (80%) of the eyes were treatment successes after 2.6 ± 1.9 needling revisions, with a mean intraocular pressure (IOP) of 13.9 ±...
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Purpose: To evaluate the outcome after Ahmed valve implantation in patients with neovascular glaucoma when using intraoperative mitomycin C (MMC) and postoperative 5-fluorouracil (5-FU). Methods: A total of 40 eyes of 40 patients with neovascular glaucoma who received antiglacomatous medication without previous glaucoma surgery were included in the present study. The patients received Ahmed valve implantation and intraoperative MMC and postoperative 5-FU. Failure was defined as the first occurre...
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