title: Revision of trabeculectomy filtering blebs with mitomycin C: Long term results.
abstract: OBJECTIVE
  The aim of the study is to assess the outcomes of transconjunctival mitomycin C (MMC)-augmented revision in eyes with failed trabeculectomy.
  
  
  METHODS
  This is a retrospective, noncomparative case series. One hundred and twenty-one eyes of 113 consecutive glaucoma patients with previously failed trabeculectomy who underwent transconjunctival revision with at least 12 months of follow-up were initially included in the study. The success was determined on the basis of intraocular pressure (IOP) alone. The main outcome measures were IOP, best-corrected distance visual acuity, complications, bleb appearance, lens status, visual field progression, and time between primary trabeculectomy and MMC revision. The main purpose of the study was to determine the efficacy of a single MMC-augmented needle revision.
  
  
  RESULTS
  Mean follow-up was 2.3 years. Twelve months after revision, IOP had declined from 26.1 ± 8.4 mmHg to 14.1 ± 4.8 mmHg (P < 0.05) and remained 16.0 ± 5.6 mmHg at 24 months, 15.7 ± 5.8 mmHg at 48 months, and 15.2 ± 4.0 mmHg at 60 months. Complete success was achieved in 53% of cases, 84% achieved qualified success, and 16% were classified as failures 12 months after revision. Early complications developed in 45 of the initial 121 eyes (37.2%).
  
  
  CONCLUSIONS
  Transconjunctival MMC-augmented revision appears to be a safe and useful tool in reducing IOP and re-establishing filtration after trabeculectomy failure. This simple procedure has a high rate of success and helps avoid other surgical interventions which are more destructive for the conjunctiva.
authors.affiliation: Department of Diagnostic and Microsurgery of Glaucoma, Medical University of Lublin, Lublin, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Tulidowicz-Bielak
authors.affiliation: Department of Diagnostic and Microsurgery of Glaucoma, Medical University of Lublin, Lublin, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Kosior-Jarecka
authors.affiliation: Department of Diagnostic and Microsurgery of Glaucoma, Medical University of Lublin, Lublin, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Żarnowski
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage*; D019384:Nucleic Acid Synthesis Inhibitors / Q000008:administration & dosage; D009883:Ophthalmic Solutions; D011183:Postoperative Complications / Q000628:therapy*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D014130:Trabeculectomy / Q000009:adverse effects*; D017211:Treatment Failure; D014792:Visual Acuity
chemical_list: D019384:Nucleic Acid Synthesis Inhibitors; D009883:Ophthalmic Solutions; D016685:Mitomycin