title: Outcomes of Bleb Revision With Mitomycin C After Ex-PRESS Shunt Surgery.
abstract: OBJECTIVE
  Investigate efficacy and safety of bleb revision using mitomycin C after Ex-PRESS shunt surgery.
  
  
  METHODS
  We performed chart reviews of 36 consecutive eyes from 34 patients with previous Ex-PRESS shunt surgery who underwent subsequent bleb revision with mitomycin C. The mean follow-up time was 13.5 months. The primary outcome measure was surgical success. Secondary outcomes included visual acuity, intraocular pressure, number of medications, and complications.
  
  
  RESULTS
  Twenty-four eyes had open-angle glaucoma (61.1%). Mean time from Ex-PRESS to bleb revision was 8.8 months. Complete success rate for the immediate 3-month postoperative period was 94.4% and qualified success rate was 97.2%. Complete and qualified success rates for the entire follow-up period were 40% and 65.7%, respectively. Visual acuity remained stable throughout the study period, and at 1 year, average intraocular pressure was 14.7 mm Hg on an average of 1.7 medications. No major complications were reported.
  
  
  CONCLUSIONS
  Bleb revision in eyes with an Ex-PRESS shunt is a safe and efficacious procedure. The surgical outcomes are within the range of published outcomes for bleb needling after trabeculectomy. Further research with larger sample size and longer follow-up is needed to confirm these results.
authors: *Dean McGee Eye Institute †University of Oklahoma College of Medicine ‡Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
authors: Evan J
authors: EJ
authors: Allan
authors: Joshua M
authors: JM
authors: Jones
authors: Kai
authors: K
authors: Ding
authors: Mahmoud A
authors: MA
authors: Khaimi
mesh_terms: D000368:Aged; D000477:Alkylating Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D005260:Female; D020327:Glaucoma Drainage Implants; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D019919:Prosthesis Implantation; D012086:Reoperation; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin