Needle Revision with and without Mitomycin C for the Teatment of Failed Filtering Blebs after Trabeculectomy

In Ho Roh1
Estimated H-index: 1
,
Sung Min Hyung4
Estimated H-index: 4
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Abstract
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. Results: First NR was done at 1.31.2 months (range, 0.26.5 months) after trabeculectomy, and a mean of 1.61.6 NRs per patient were done. The follow-up period was 24.420.4 months (range, 6.087.4 months) after the last NR. Pre-NR mean IOP was 27.911.6 mm Hg and post-NR final IOP was 18.813.0 mm Hg (p=0.005). The success rate, defined as IOP 18 mm Hg with or without medication, was 80.3% (25 eyes of 31 eyes). The success rate was higher in the group receiving NR with adjunctive MMC (100%) than in the group receiving NR without MMC (62.5%) (p=0.018). Patients who underwent trabeculectomy without adjunctive MMC and those who had pre-NR IOP >25 mm Hg showed a higher failure rate, though with no statistical significance (p=0.141 and p=0.173, respectively). Conclusions: NR followed by subconjunctival injection of MMC is an effective and safe method for the treatment of the failed filtering blebs after trabeculectomy. Trabeculectomy without adjunctive MMC and pre-NR IOP higher than 25 mmHg were risk factors for failure of NR. J Korean Ophthalmol Soc 47(7):1087-1092, 2006
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#1Kyeong Jin Woo (CBNU: Chungbuk National University)H-Index: 3
#2Sungmin Hyung (CBNU: Chungbuk National University)H-Index: 4
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 adjac...
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