Purpose: To evaluate the results of bleb needling in eyes subjected to filtering surgery six months or more previously. Methods: A retrospective study of 23 eyes in 21 patients subjected to bleb needling performed by means of a 25G needle, 6 months to 23 years after failed filtering surgery (mean 67.3 months). The mean number of bleb needlings was 1.2 and the mean number of 5-fluorouracil subconjunctival injections was 3.9. Results: The mean intraocular pressure (IOP) before needling was 26 mmHg and the mean anti-glaucoma medications was 1.3 per eye. The mean postoperative IOP was 16.3 mmHg and mean antiglaucoma medications 0.7. A diffuse filtering bleb was evident in 12 eyes (54.5%). The results of needling were worse in eyes subjected to previous surgery for glaucoma or other failed bleb needling procedures (75% failure). Conclusion: Needle revision of the filtering bleb is a simple and safe technique that offers good results even years after a filtering surgery had been perfor- ORIGINAL ARTICLE RESUMENObjetivo: Analizar los resultados de la cistitomía de la ampolla de filtración en ojos operados de cirugía filtrante de glaucoma seis meses antes o más. Material y métodos: Estudio retrospectivo de 23 ojos de 21 pacientes en los que se ha realizado revisión de la ampolla de filtración con una aguja de 25 G, entre 6 meses y 23 años tras cirugía filtrante (media 67,3 meses). Se realizaron una media de 1,2 cistitomías por ojo y 3,9 inyecciones de 5-fluorouracilo subconjuntival. Resultados: De una presión intraocular (PIO) media preoperatoria de 26 mmHg y 1,3 fármacos hipotensores hemos pasado a una PIO media postoperatoria de 16,3 mmHg y una media de 0,7 fárma-cos, con una ampolla de filtración difusa en 12 casos (54,5%). Los resultados fueron peores en ojos con cirugía previa de glaucoma u otra cistitomía previa fracasada (75% fracaso). Conclusiones: La revisión con aguja es una técnica sencilla y segura que ofrece buenos resultados incluso años después de una cirugía filtrante, y debe ser considerada de manera previa a la reinstaura-518 ARCH SOC ESP OFTALMOL 2006; 81: 517-522 PERUCHO-MARTÍNEZ S, et al.

This is the first reported case of Propionibacterium acnes endophthalmitis in an Ahmed glaucoma valve and the second one in a glaucoma drainage device. We strongly recommend using a patch graft to prevent and treat tube exposure. Conjunctival grafts may be useful to close the conjunctiva when there is marked scarring to prevent patch exposure and melting or extrusion.

Human preserved fascia lata is a suitable material for tube covering in glaucoma drainage device surgery, with long-term survival.

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