Needling revision of failed filtering blebs after trabeculectomy: a retrospective study.
OBJECTIVE
To determine the efficacy and safety of needling revision of failed filtering blebs.


METHODS
We reviewed retrospectively 26 eyes that had undergone needling revision for a failed trabeculectomy. The needling revisions were performed either with adjunctive use of Mitomycin C, 5-Fluorouracil or without antimetabolites. The procedure was usually performed as a clinic procedure, using a 27-gauge needle.


RESULTS
The mean follow-up time was 14.5 +/- 11.3 months (range 6.0-48.0 months). Intraocular pressure (IOP) decreased from 28.8 +/- 6.8 mmHg (range 19.0-40.0 mmHg) to 15.3 +/- 5.2 mmHg (range 7.0-35.0 mmHg). Twelve eyes (46.2%) achieved success, defined as IOP < or = 18 mmHg without medication; 11 eyes (42.3%) achieved qualified success, defined as IOP < or = 18 mmHg with antiglaucomatous medication, and three of 26 eyes (11.5%) were classified as failures. The success rate after the initial needling was 64% at 6 months and the same after 1 year and 2 years. The success rate after one or more needlings was 96% at 6 months and 77% at 1 year and 2 years. Complications developed in six of the 26 eyes (23.1%). These involved transient corneal epithelial defects in three eyes (11.5%), temporary conjunctival wound leak in two eyes (7.7%), and development of bullous keratopathy in one high risk eye (3.8%).


CONCLUSIONS
Our results are comparable to the results of other studies. Needling revision appears to be a useful tool in the management of glaucoma.
Fagerli
Marit
M
Department of Ophthalmology, St. Olav University Hospital, Trondheim, Norway. marit.fagerli@stolav.no
Løfors
Kjell T
KT
Elsås
Tor
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002675:Child, Preschool; D003228:Conjunctiva / Q000187:drug effects; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009339:Needles; D011677:Punctures / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D012449:Safety; D014130:Trabeculectomy; D017211:Treatment Failure
D016685:Mitomycin; D005472:Fluorouracil