title: Anti-inflammatory fibrosis suppression in threatened trabeculectomy bleb failure produces good long term control of intraocular pressure without risk of sight threatening complications.
abstract: 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.
authors.affiliation: Department of Ophthalmology, University of Otago Medical School, Dunedin, New Zealand.
authors.forename: J R
authors.initials: JR
authors.lastname: Fuller
authors.forename: T H
authors.initials: TH
authors.lastname: Bevin
authors.forename: A C B
authors.initials: AC
authors.lastname: Molteno
authors.forename: B J T
authors.initials: BJ
authors.lastname: Vote
authors.forename: P
authors.initials: P
authors.lastname: Herbison
mesh_terms: 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*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam; D004008:Diclofenac; D005439:Flufenamic Acid; D003078:Colchicine; D011241:Prednisone; C032801:tenoxicam