Research Article
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Year 2019, Volume: 5 Issue: 6, 990 - 995, 04.11.2019
https://doi.org/10.18621/eurj.425740

Abstract

References

  • [1] Errico D, Scrimieri F, Riccardi R, Fedeli R, Iarossi G. Trabeculectomy with double low dose of mitomycin C - two years of follow-up. Clin Ophthalmol 2011;5:1679-86.
  • [2] Azuara-Blanco A, Katz LJ. Dysfunctional filtering blebs. Surv Ophthalmol 1998;43:93-126.
  • [3] Yarangümeli A, Köz OG, Kural G. Encapsulated blebs following primary standard trabeculectomy: course and treatment. J Glaucoma 2004;13:251-5.
  • [4] Schwartz AL, Van Veldhuisen PC, Gaasterland DE, Ederer F, Sullivan EK, Cyrlin MN. The Advanced Glaucoma Intervention Study (AGIS): 5. Encapsulated bleb after initial trabeculectomy. Am J Ophthalmol 1999;127:8-19.
  • [5] Van Buskirk EM. Cysts of Tenon’s capsule following filtration surgery. Am J Ophthalmol 1982;94:522-7.
  • [6] Mandal AK. Results of medical management and mitomycin C-augmented excisional bleb revision for encapsulated filtering blebs. Ophthalmic Surg Lasers 1999;30:276-84.
  • [7] Ferrer H. Conjunctival dialysis in the treatment of glaucoma recurrent after sclerectomy. Am J Ophthalmol 1941;24:788-90.
  • [8] Addicks EM, Quigley HA, Green WR, Robin AL. Histologic characteristics of filtreing blebs in glaucomatous eyes. Arch Ophthalmol 1983;101:795-8.
  • [9] Skuta GL, Parrish RK: II. Wound healing in glaucoma filtration surgery. Surv Ophthalmol 1987;32:149-70.
  • [10] Ophir A. Encapsulated filtering bleb. A selective review-new deductions. Eye 1992;6:348-52.
  • [11] Kapasi MS, Birt CM. The efficacy of 5-fluorouracil bleb needling performed 1 year or more posttrabeculectomy: a retrospective study. J Glaucoma 2009;18:144-8.
  • [12] Paris G, Zhao M, Sponsel WE. Operative revision of non-functioning filtering blebs with 5-fluorouracil to regain intraocular pressure control. Clin Experiment Ophthalmol 2004;32:378-82.
  • [13] Broadway DC, Bloom PA, Bunce C, Thiagarajan M, Khaw PT. Needle revision of failing and failed trabeculectomy blebs with adjunctive 5-fluorouracil: survival analysis. Ophthalmology 2004;111:665-73.
  • [14] Suzuki R, Susanna R Jr. Early transconjunctival needling revision with 5-fluorouracil versus medical treatment in encapsulated blebs: a 12-month prospective study. Clinics (sao Paulo) 2013;68:1376-9.
  • [15] Panarelli JF, Vinod K, Huang G, Sidoti PA. Transconjunctival revision with mitomycin-C following failed trabeculectomy. J Glaucoma 2016;25:618-22.
  • [16] Mardelli PG, Lederer CM Jr, Murray PL, Pastor SA, Hassanein KM. Slit-lamp needle revision of failed filtering blebs using mitomycin C. Ophthalmology 1996;103:1946-55.
  • [17] Palejwala N, Ichhpujani P, Fakhraie G, Myers JS, Moster MR, Katz LJ. Single needle revision of failing filtration blebs: a retrospective comparative case series with 5-fluorouracil and mitomycin C. Eur J Ophthalmol 2010;20:1026-34.
  • [18] Anand N, Khan AJ. Glaucoma. Long-term outcomes of needle revision of trabeculectomy blebs with mitomycin C and 5-fluorouracil: a comparative safety and efficacy report. J Glaucoma 2009;18:513-20.
  • [19] Iwach AG, Delgado MF, Novack GD, Nguyen N, Wong PC. Transconjunctival mitomycin-C in needle revisions of filtering blebs. Ophthalmology 2003;110:734-42.
  • [20] Gutierrez-Ortiz C, Cabarga C, Teus MA. Prospective evaluation of preoperative factors associated with successful mitomycin C needling of failed filtration blebs. J Glaucoma 2006;15:98-102.
  • [21] Shetty RK, Wartluft L, Moster MR. Slit-lamp needle revision of failed fi ltering blebs using high-dose mitomycin C. J Glaucoma 2005;14:52-6.
  • [22] Shin DH, Kim YY, Ginde SY, Kim PH, Eliassi-Rad B, Khatana AK, et al. Risk factors for failure of 5-fluorouracil needling revision for failed conjunctival filtration blebs. Am J Ophthalmol 2001;132:875-80.
  • [23] Rashad MA. Efficacy of repeated 5-fluorouracil needling for failing and failed filtering surgeries based on simple gonioscopic examination. Clin Ophthalmol 2013;7:15-22.

The efficacy of bleb needling revision with 5-fluorouracil in encapsulated bleb after unsuccessful trabeculectomy

Year 2019, Volume: 5 Issue: 6, 990 - 995, 04.11.2019
https://doi.org/10.18621/eurj.425740

Abstract

Objectives: To investigate the efficacy of the bleb needling
revision (BNR) procedure with the adjunctive use of 5-Fluorouracil (5-FU) in
encapsulated bleb after unsuccessful trabeculectomy.

Methods: We reviewed 16 eyes of 15 subjects who underwent BNR
procedure
due to encapsulated
bleb after unsuccessful trabeculectomy. Demographic data, type of glaucoma,
intraocular pressure (IOP) values of pre-BNR, IOP values of post-BNR at first
day, first week and first month, follow up time and complications were recorded
from patients’ files,
retrospectively.

Results: The mean follow up time was
53.1 ± 26.4 weeks.
The average
time between previous unsuccessful trabeculectomy and BNR
was 11.12 ± 8.79 weeks. The mean IOP
of pre-BNR was 26.0 
± 4.4 mmHg and
significantly decreased to 12.4 ± 5.0 mmHg post-BNR at the first day (
p <
0.001). The mean IOP values of post-BNR at the first week was 13.3 ± 4.9 mmHg
and at the first month was 14.8 ± 4.8 mmHg. According to the
mean IOP of
pre-BNR,
the mean IOP values of
post-BNR at the first week and at the first month were significantly lower (p <
0.001 and p < 0.001, respectively). Seven (44%) eyes were achieved success and
eight (50%) eyes were achieved
qualified success. One (6%) eye was
classified as the failure.







Conclusion: The bleb needling revision procedure with the
adjunctive use of 5-FU in encapsulated bleb after unsuccessful trabeculectomy
is a simple, useful and repeatable method to restore the dysfunctional bleb. 

References

  • [1] Errico D, Scrimieri F, Riccardi R, Fedeli R, Iarossi G. Trabeculectomy with double low dose of mitomycin C - two years of follow-up. Clin Ophthalmol 2011;5:1679-86.
  • [2] Azuara-Blanco A, Katz LJ. Dysfunctional filtering blebs. Surv Ophthalmol 1998;43:93-126.
  • [3] Yarangümeli A, Köz OG, Kural G. Encapsulated blebs following primary standard trabeculectomy: course and treatment. J Glaucoma 2004;13:251-5.
  • [4] Schwartz AL, Van Veldhuisen PC, Gaasterland DE, Ederer F, Sullivan EK, Cyrlin MN. The Advanced Glaucoma Intervention Study (AGIS): 5. Encapsulated bleb after initial trabeculectomy. Am J Ophthalmol 1999;127:8-19.
  • [5] Van Buskirk EM. Cysts of Tenon’s capsule following filtration surgery. Am J Ophthalmol 1982;94:522-7.
  • [6] Mandal AK. Results of medical management and mitomycin C-augmented excisional bleb revision for encapsulated filtering blebs. Ophthalmic Surg Lasers 1999;30:276-84.
  • [7] Ferrer H. Conjunctival dialysis in the treatment of glaucoma recurrent after sclerectomy. Am J Ophthalmol 1941;24:788-90.
  • [8] Addicks EM, Quigley HA, Green WR, Robin AL. Histologic characteristics of filtreing blebs in glaucomatous eyes. Arch Ophthalmol 1983;101:795-8.
  • [9] Skuta GL, Parrish RK: II. Wound healing in glaucoma filtration surgery. Surv Ophthalmol 1987;32:149-70.
  • [10] Ophir A. Encapsulated filtering bleb. A selective review-new deductions. Eye 1992;6:348-52.
  • [11] Kapasi MS, Birt CM. The efficacy of 5-fluorouracil bleb needling performed 1 year or more posttrabeculectomy: a retrospective study. J Glaucoma 2009;18:144-8.
  • [12] Paris G, Zhao M, Sponsel WE. Operative revision of non-functioning filtering blebs with 5-fluorouracil to regain intraocular pressure control. Clin Experiment Ophthalmol 2004;32:378-82.
  • [13] Broadway DC, Bloom PA, Bunce C, Thiagarajan M, Khaw PT. Needle revision of failing and failed trabeculectomy blebs with adjunctive 5-fluorouracil: survival analysis. Ophthalmology 2004;111:665-73.
  • [14] Suzuki R, Susanna R Jr. Early transconjunctival needling revision with 5-fluorouracil versus medical treatment in encapsulated blebs: a 12-month prospective study. Clinics (sao Paulo) 2013;68:1376-9.
  • [15] Panarelli JF, Vinod K, Huang G, Sidoti PA. Transconjunctival revision with mitomycin-C following failed trabeculectomy. J Glaucoma 2016;25:618-22.
  • [16] Mardelli PG, Lederer CM Jr, Murray PL, Pastor SA, Hassanein KM. Slit-lamp needle revision of failed filtering blebs using mitomycin C. Ophthalmology 1996;103:1946-55.
  • [17] Palejwala N, Ichhpujani P, Fakhraie G, Myers JS, Moster MR, Katz LJ. Single needle revision of failing filtration blebs: a retrospective comparative case series with 5-fluorouracil and mitomycin C. Eur J Ophthalmol 2010;20:1026-34.
  • [18] Anand N, Khan AJ. Glaucoma. Long-term outcomes of needle revision of trabeculectomy blebs with mitomycin C and 5-fluorouracil: a comparative safety and efficacy report. J Glaucoma 2009;18:513-20.
  • [19] Iwach AG, Delgado MF, Novack GD, Nguyen N, Wong PC. Transconjunctival mitomycin-C in needle revisions of filtering blebs. Ophthalmology 2003;110:734-42.
  • [20] Gutierrez-Ortiz C, Cabarga C, Teus MA. Prospective evaluation of preoperative factors associated with successful mitomycin C needling of failed filtration blebs. J Glaucoma 2006;15:98-102.
  • [21] Shetty RK, Wartluft L, Moster MR. Slit-lamp needle revision of failed fi ltering blebs using high-dose mitomycin C. J Glaucoma 2005;14:52-6.
  • [22] Shin DH, Kim YY, Ginde SY, Kim PH, Eliassi-Rad B, Khatana AK, et al. Risk factors for failure of 5-fluorouracil needling revision for failed conjunctival filtration blebs. Am J Ophthalmol 2001;132:875-80.
  • [23] Rashad MA. Efficacy of repeated 5-fluorouracil needling for failing and failed filtering surgeries based on simple gonioscopic examination. Clin Ophthalmol 2013;7:15-22.
There are 23 citations in total.

Details

Primary Language English
Subjects Ophthalmology
Journal Section Original Articles
Authors

Mehmet Okka 0000-0002-3908-1042

Enver Mirza 0000-0002-8847-5726

Refik Oltulu 0000-0003-2447-6524

Selman Belviranlı This is me 0000-0002-4177-6046

Mehmet Kemal Gündüz This is me 0000-0001-9105-6429

Publication Date November 4, 2019
Submission Date May 21, 2018
Acceptance Date January 22, 2019
Published in Issue Year 2019 Volume: 5 Issue: 6

Cite

AMA Okka M, Mirza E, Oltulu R, Belviranlı S, Gündüz MK. The efficacy of bleb needling revision with 5-fluorouracil in encapsulated bleb after unsuccessful trabeculectomy. Eur Res J. November 2019;5(6):990-995. doi:10.18621/eurj.425740

e-ISSN: 2149-3189 


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