| 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. |
| Authors | Mustafa S Kapasi, Catherine M Birt
(Affiliation: Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada.)
|
| Journal | Journal of glaucoma
(J Glaucoma)
Vol. 18
Issue 2
Pg. 144-8
(Feb 2009)
ISSN: 1536-481X [Electronic] United States |
| PMID | 19225352
(Publication Type: Comparative Study, Journal Article)
|
| Chemical References |
- Immunosuppressive Agents
- Fluorouracil
|
| Topics |
- Aged
- Aged, 80 and over
- Conjunctiva
(drug effects, pathology)
- Female
- Fluorouracil
(administration & dosage)
- Follow-Up Studies
- Glaucoma
(surgery)
- Humans
- Immunosuppressive Agents
(administration & dosage)
- Male
- Middle Aged
- Postoperative Complications
(drug therapy, pathology)
- Punctures
(instrumentation)
- Reoperation
- Retrospective Studies
- Trabeculectomy
(adverse effects)
- Treatment Outcome
|
