Treatment of encapsulated blebs with 30-gauge needling and injection of low-dose 5-fluorouracil.

We describe a simplified needling procedure, performed at the slit-lamp, with injection of low-dose 5-fluorouracil to treat encapsulated filtering blebs. Between August 1989 and December 1990 we treated 17 eyes of 14 patients with this procedure. At 2 months 13 of the eyes had needed only one needling procedure. Risk factors for reencapsulation of the bleb were a history of three or more previous surgical procedures (p less than 0.05) and prolonged preoperative use of topical adrenergic drugs (p less than 0.05). At 1 year all but one eye had an intraocular pressure below 21 mm Hg (median 15 mm Hg). Twelve of the eyes had needed more than one needling procedure. There were no serious complications of the 32 procedures performed. The incidence rate of minor complications (wound leaks, corneal erosion and small hyphemas) was 38%.