Needling with intra-bleb 5 fluorouracil for intractable neovascular glaucoma.
OBJECTIVE
Trabeculectomy for neovascular glaucoma (NVG) often results in filtering bleb scarring. The outcome of a needling procedure with intra-bleb 5-fluorouracil (5-FU) administration in NVG eyes is presented.


METHODS
Following trabeculectomy with mitomycin C (MMC), intraocular pressures (IOPs) ranged between 36 to 56 mm Hg in 3 painful, neovascular glaucomatous eyes despite treatment. Each eye was then injected subconjunctivally with 1.0 mg of 5-FU, adjacent to and within the filtering bleb. The needle was advanced and penetration into the anterior chamber through the bled, anterior to the scleral flap, followed.


RESULTS
In each eye, the IOP dropped immediately. After 18 to 29 months, IOPs were 11 to 22 mm Hg, and in two eyes-without hypotensive medications. Cataract progression was evident in the 2 eyes that had had cataracts preoperatively.


CONCLUSIONS
The postoperative needling, in conjunction with the dual effect of intraoperative MMC and intra-bleb 5-FU, was found efficacious and saved further surgery in these intractable cases.
Ophir
A
A
Department of Ophthalmology, Hillel-Yaffe Medical Center, Hadera, Israel.
Porges
Y
Y
D000368:Aged; D000867:Anterior Chamber; D000963:Antimetabolites / Q000627:therapeutic use*; D003228:Conjunctiva; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D015355:Glaucoma, Neovascular / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009339:Needles; D011183:Postoperative Complications / Q000628:therapy*; D014130:Trabeculectomy / Q000009:adverse effects; D014792:Visual Acuity
D000963:Antimetabolites; D005472:Fluorouracil