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Mitomycin-C needle bleb revision in congenital glaucoma.

Elsayed TH, El-Raggal TM - Middle East Afr J Ophthalmol (2010)

Bottom Line: One needling revision was performed in 22 eyes (73.3%) and eight eyes (26.7%) received two needle revisions.The mean intraocular pressure (IOP) decreased from 26.9 ± 2.85 mmHg (range, 21-34 mmHg) before surgery to 15.63 ± 3.15 mmHg (range, 10-24 mmHg) at last follow-up.This technique is effective in reducing IOP with preservation of the remaining conjunctiva for further surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

ABSTRACT

Unlabelled: PURPOSE AND SETTINGS: This study was designed to evaluate the efficacy and safety of mitomycin-C (MMC) augmented needling procedure in the management of failed bleb after trabeculectomy in congenital glaucoma. This study was carried out at Ain Shams University Hospital.

Patients and methods: A retrospective study was carried on 30 eyes of 25 patients with congenital glaucoma with bleb failure after trabeculectomy. The mean age of the subjects was 7.3 ± 3.4 years (range, 1-12 years). Under general anesthesia, needling procedure was performed with adjunctive use of a mixture of 0.1 mL of MMC (0.04 mg/mL) and 0.2 mL of lidocaine 1% injected subconjunctivally. Needling was performed with a 30-gauge needle to dissect the areas of subconjunctival fibrosis and re-establish aqueous outflow.

Results: Follow-up ranged from 6 to 20 months (mean, 9.23 ± 5.25 months). One needling revision was performed in 22 eyes (73.3%) and eight eyes (26.7%) received two needle revisions. The mean intraocular pressure (IOP) decreased from 26.9 ± 2.85 mmHg (range, 21-34 mmHg) before surgery to 15.63 ± 3.15 mmHg (range, 10-24 mmHg) at last follow-up. Complications included significant subconjunctival hemorrhage in six eyes, intraoperative bleb leak in two eyes, choroidal detachment in one eye, and minimal hyphema in one eye.

Conclusion: MMC needle bleb revision appears to be an effective method to revive failed filtration surgery after trabeculectomy in patients with congenital glaucoma. This technique is effective in reducing IOP with preservation of the remaining conjunctiva for further surgery.

No MeSH data available.


Related in: MedlinePlus

Final results in needle bleb revision
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Figure 0001: Final results in needle bleb revision

Mentions: Of the 30 eyes included, 22 eyes (73.3%) underwent one needle revision and eight eyes (26.7%) underwent two needle revisions. For the eight eyes that underwent a second needle revision, four eyes (50%) succeeded and the remaining four eyes failed. Needle revision was successful in 17 cases (56.7%), qualified success occurred in nine cases (30%), and failure occurred in four cases (13.3%) [Figure 1]. Higher success rate was obtained in eyes with a mean preoperative IOP 24.9 ± 1.7 mmHg.


Mitomycin-C needle bleb revision in congenital glaucoma.

Elsayed TH, El-Raggal TM - Middle East Afr J Ophthalmol (2010)

Final results in needle bleb revision
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2991458&req=5

Figure 0001: Final results in needle bleb revision
Mentions: Of the 30 eyes included, 22 eyes (73.3%) underwent one needle revision and eight eyes (26.7%) underwent two needle revisions. For the eight eyes that underwent a second needle revision, four eyes (50%) succeeded and the remaining four eyes failed. Needle revision was successful in 17 cases (56.7%), qualified success occurred in nine cases (30%), and failure occurred in four cases (13.3%) [Figure 1]. Higher success rate was obtained in eyes with a mean preoperative IOP 24.9 ± 1.7 mmHg.

Bottom Line: One needling revision was performed in 22 eyes (73.3%) and eight eyes (26.7%) received two needle revisions.The mean intraocular pressure (IOP) decreased from 26.9 ± 2.85 mmHg (range, 21-34 mmHg) before surgery to 15.63 ± 3.15 mmHg (range, 10-24 mmHg) at last follow-up.This technique is effective in reducing IOP with preservation of the remaining conjunctiva for further surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

ABSTRACT

Unlabelled: PURPOSE AND SETTINGS: This study was designed to evaluate the efficacy and safety of mitomycin-C (MMC) augmented needling procedure in the management of failed bleb after trabeculectomy in congenital glaucoma. This study was carried out at Ain Shams University Hospital.

Patients and methods: A retrospective study was carried on 30 eyes of 25 patients with congenital glaucoma with bleb failure after trabeculectomy. The mean age of the subjects was 7.3 ± 3.4 years (range, 1-12 years). Under general anesthesia, needling procedure was performed with adjunctive use of a mixture of 0.1 mL of MMC (0.04 mg/mL) and 0.2 mL of lidocaine 1% injected subconjunctivally. Needling was performed with a 30-gauge needle to dissect the areas of subconjunctival fibrosis and re-establish aqueous outflow.

Results: Follow-up ranged from 6 to 20 months (mean, 9.23 ± 5.25 months). One needling revision was performed in 22 eyes (73.3%) and eight eyes (26.7%) received two needle revisions. The mean intraocular pressure (IOP) decreased from 26.9 ± 2.85 mmHg (range, 21-34 mmHg) before surgery to 15.63 ± 3.15 mmHg (range, 10-24 mmHg) at last follow-up. Complications included significant subconjunctival hemorrhage in six eyes, intraoperative bleb leak in two eyes, choroidal detachment in one eye, and minimal hyphema in one eye.

Conclusion: MMC needle bleb revision appears to be an effective method to revive failed filtration surgery after trabeculectomy in patients with congenital glaucoma. This technique is effective in reducing IOP with preservation of the remaining conjunctiva for further surgery.

No MeSH data available.


Related in: MedlinePlus