title: Office-based slit-lamp needle revision with adjunctive mitomycin-C for late failed or encapsulated filtering blebs.
abstract: OBJECTIVE
  The purpose of this study was to assess the results of bleb needling in glaucomatous patients with late failed filtering blebs.
  
  
  METHODS
  A retrospective case series of 27 eyes of 27 patients was considered. All patients underwent needle bleb revision with adjuvant mitomycin-C performed at the slit lamp, during an office visit. Complete success was defined as postneedling intraocular pressure (IOP) ≤ 21 mmHg without any antiglaucoma medications and qualified success was IOP ≤ 21 mmHg with topical antiglaucoma medications.
  
  
  RESULTS
  There were 12 eyes with encapsulated blebs and 15 eyes with flat blebs. The mean interval between index filtering surgery and bleb revision was 32.74 ± 15.36 months. Mean IOP was 25.07 ± 4.80 mmHg before surgery and 19.66 ± 4.97 mmHg at last postoperative follow-up. The mean follow-up was 20.31 ± 15.63 months. Complete and qualified successes were 7.4% and 51.9%, respectively. Cumulative rates of success at 1, 2, 3, and 4 years were 76%, 65%, 49%, and 37%, respectively. The mean number of antiglaucoma medications was reduced from 3.15 ± 0.36 preoperatively to 2.33 ± 1.21 postoperatively (P<0.001).
  
  
  CONCLUSIONS
  Slit-lamp needle revision in office is a simple and effective method for treating late encapsulated or flat filtering blebs without significant complications even for late bleb failure.
authors.affiliation: Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Heidar
authors.initials: H
authors.lastname: Amini
authors.forename: Alireza
authors.initials: A
authors.lastname: Esmaili
authors.forename: Reza
authors.initials: R
authors.lastname: Zarei
authors.forename: Nima
authors.initials: N
authors.lastname: Amini
authors.forename: Ramin
authors.initials: R
authors.lastname: Daneshvar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D003228:Conjunctiva / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D010030:Ostomy / Q000295:instrumentation*; D012086:Reoperation; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D014130:Trabeculectomy; D017211:Treatment Failure
chemical_list: D000964:Antimetabolites, Antineoplastic; D016685:Mitomycin