title: Neodymium: YAG transconjunctival laser revision of late-failing filtering blebs.
abstract: OBJECTIVE
  To study the effectiveness of neodymium:YAG (Nd:YAG) laser transconjunctival revision of late-failing filtering blebs.
  
  
  METHODS
  Retrospective, noncomparative case series.
  
  
  METHODS
  Thirty consecutive patients from a glaucoma referral practice at the Ohio State University Department of Ophthalmology.
  
  
  METHODS
  Transconjunctival Nd:YAG laser revision of blebs diagnosed as failing secondary to episcleral fibrosis.
  
  
  METHODS
  Reduction in intraocular pressure (IOP) and survival of bleb.
  
  
  RESULTS
  Reduction in IOP was attained in 24 (80%) of 30 patients with a mean prelaser IOP of 21.21 mmHg and a mean 1-week postlaser IOP of 13.97 mmHg (P < 0.0001). These results were maintained at the 1-, 3-, and 12-month follow-up visits with mean IOPs of 16.31 mmHg (P = 0.0008), 14.81 mmHg (P < 0.0001), and 15.25 mmHg (P = 0.0003), respectively. Two-year data were available on a small number of patients (4) with a mean of 15.25 mmHg (P = 0.0085). Mean time interval between trabeculectomy and laser revision was 31 months.
  
  
  CONCLUSIONS
  Late-failing filtering blebs are often amenable to Nd:YAG transconjunctival revision.
authors.affiliation: Department of Ophthalmology, Ohio State University, Columbus 43210, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Weber
authors.forename: J H
authors.initials: JH
authors.lastname: Jones
authors.forename: F
authors.initials: F
authors.lastname: Kapetansky
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003228:Conjunctiva / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005355:Fibrosis / Q000150:complications; D005901:Glaucoma / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D012590:Sclera / Q000473:pathology; D012599:Sclerostomy; D014130:Trabeculectomy; D017211:Treatment Failure; D014463:Ultrasonography