Mustafa S Kapasi1, Catherine M Birt. 1. Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada.
Abstract
PURPOSE: To determine the efficacy of a subconjunctival needling revision using 5-fluorouracil (5FU) when administered to patients who have nonfiltering, flat, or encapsulated blebs over 1 year after the original surgery. METHODS: The charts of 37 glaucoma patients, who had undergone both a trabeculectomy filtering procedure and a subconjunctival 5FU needling revision, with a minimum interval of 1 year between these procedures and with no intervening surgical procedures, were retrospectively reviewed. The needling was a clinic procedure using a 30-gauge needle and 0.1 mL of 50 mg/mL 5FU. RESULTS: Intraocular pressure (IOP) decreased by an average of 10.5 mm Hg (44.8%) immediately after the needling procedure. Eleven eyes (29.7%) achieved absolute success, defined as IOP control with no further needling revision, surgical intervention, or antiglaucoma medication in the 2-year follow-up period. Thirteen eyes (35.1%) achieved a qualified success, defined as IOP control with resumed medication use, undergoing a laser procedure, or a repeat needling within the follow-up period. Thirteen eyes (35.1%) failed the procedure by requiring a repeat surgical intervention. The mean IOP was 16.3+/-4.6 mm Hg in the success group, 15.5+/-6.5 mm Hg in the qualified success group, and 27.7+/-8.9 mm Hg in the failure group at the end of follow-up. CONCLUSIONS: Late 5FU needling is an effective method to control IOP and avoid further surgery in a high proportion of patients with medically uncontrolled nonfiltering blebs.
PURPOSE: To determine the efficacy of a subconjunctival needling revision using 5-fluorouracil (5FU) when administered to patients who have nonfiltering, flat, or encapsulated blebs over 1 year after the original surgery. METHODS: The charts of 37 glaucomapatients, who had undergone both a trabeculectomy filtering procedure and a subconjunctival 5FU needling revision, with a minimum interval of 1 year between these procedures and with no intervening surgical procedures, were retrospectively reviewed. The needling was a clinic procedure using a 30-gauge needle and 0.1 mL of 50 mg/mL 5FU. RESULTS: Intraocular pressure (IOP) decreased by an average of 10.5 mm Hg (44.8%) immediately after the needling procedure. Eleven eyes (29.7%) achieved absolute success, defined as IOP control with no further needling revision, surgical intervention, or antiglaucoma medication in the 2-year follow-up period. Thirteen eyes (35.1%) achieved a qualified success, defined as IOP control with resumed medication use, undergoing a laser procedure, or a repeat needling within the follow-up period. Thirteen eyes (35.1%) failed the procedure by requiring a repeat surgical intervention. The mean IOP was 16.3+/-4.6 mm Hg in the success group, 15.5+/-6.5 mm Hg in the qualified success group, and 27.7+/-8.9 mm Hg in the failure group at the end of follow-up. CONCLUSIONS: Late 5FU needling is an effective method to control IOP and avoid further surgery in a high proportion of patients with medically uncontrolled nonfiltering blebs.
Authors: Kevin Kaplowitz; Sarah Khodadadeh; Samantha Wang; Daniel Lee; James C Tsai Journal: Graefes Arch Clin Exp Ophthalmol Date: 2017-04-08 Impact factor: 3.117
Authors: P Laspas; P D Culmann; F H Grus; V Prokosch-Willing; A Poplawksi; N Pfeiffer; E M Hoffmann Journal: PLoS One Date: 2017-05-18 Impact factor: 3.240