Anti-inflammatory fibrosis suppression in threatened trabeculectomy bleb failure produces good long term control of intraocular pressure without risk of sight threatening complications.
OBJECTIVE
To determine the long term outcome of systemic anti-inflammatory fibrosis suppression in cases of threatened trabeculectomy bleb failure in open angle glaucoma.


METHODS
This prospective non-comparative case series followed 77 eyes of 63 patients which showed signs of threatened early bleb failure and were treated with oral anti-inflammatory fibrosis suppression of prednisone, a non-steroidal anti-inflammatory agent, and colchicine taken for a mean period of 6 weeks, in addition to standard postoperative topical treatment, for a mean follow up of 6 years.


RESULTS
Trabeculectomy with anti-inflammatory fibrosis suppression controlled the IOP at < or =21 mm Hg with a probability of 0.91 (95% CI: 0.81 to 1.0) at 8 years and 0.89 (95% CI: 0.56 to 1.1) at 12 years. There were no reported cases of endophthalmitis, hypotonous maculopathy, late bleb leak, or serious systemic side effects.


CONCLUSIONS
Anti-inflammatory fibrosis suppression provided good control of bleb fibrosis without risk of sight threatening complications in a patient group at high risk of bleb failure.
Fuller
J R
JR
Department of Ophthalmology, University of Otago Medical School, Dunedin, New Zealand.
Bevin
T H
TH
Molteno
A C B
AC
Vote
B J T
BJ
Herbison
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D003078:Colchicine / Q000009:adverse effects / Q000627:therapeutic use; D004008:Diclofenac / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005355:Fibrosis / Q000517:prevention & control; D005439:Flufenamic Acid / Q000627:therapeutic use; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010894:Piroxicam / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D011446:Prospective Studies; D014129:Trabecular Meshwork / Q000473:pathology*; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014786:Vision Disorders / Q000139:chemically induced*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam; D004008:Diclofenac; D005439:Flufenamic Acid; D003078:Colchicine; D011241:Prednisone; C032801:tenoxicam