Predictors for success of needle revision of failing filtration blebs

Hawkins, Anjali S; Flanagan, J. G.; Brown, Steven V.L.

doi:10.1016/s0161-6420(01)01016-8

Cited by 50 publications

(34 citation statements)

References 15 publications

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“…Shin et al [32] reported a mean interval of 13.6 months in a group of black subjects. In other studies, the mean intervals were 141 weeks [33] and 3.1 months [34]. Our study reported a mean interval of 7.7 months.…”

Section: Discussionsupporting

confidence: 54%

Bleb Needling with Mitomycin C as Adjunctive Therapy in Failing Blebs: A Retrospective Study

Noce

Vagge

Traverso³

2019

Ophthalmic Res

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Purpose: To evaluate the effects and complications related to use of mitomycin C (MMC) as an adjunctive therapy in bleb needling. Methods: Retrospective review of the records of patients affected by open-angle glaucoma who underwent a bleb revision as a treatment for failed trabeculectomy. All subjects underwent surgery with a fornix-based approach to incision. Full baseline data for each patient included a comprehensive ocular and medical history, the patient’s Snellen visual acuity test results, and Goldmann applanation tonometry test results. Data were reported following observations occurring at 6, 12, 18, 24, and 30 months. In addition, the number and timing of needling with or without MMC subconjunctival injections and any short- and long-term complications were observed. Results: We included 101 patients, 56 (55.4%) male and 45 (44.6%) female. The mean age was 69.81 ± 16.19 years (range 28–92). Statistically significant effects of needling and needling and MMC (p values <0.05) in the decrease in intraocular pressure were observed. Three (2.9%) patients presented hypotony at the last follow-up visit. No other complications were observed. Conclusions: Needling bleb revision augmented with the use of MMC appears to be a more useful tool in the management of failing bleb.

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Section: Discussionsupporting

confidence: 54%

Bleb Needling with Mitomycin C as Adjunctive Therapy in Failing Blebs: A Retrospective Study

Noce

Vagge

Traverso³

2019

Ophthalmic Res

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“…This may be why postoperative needling, although effective in adults, is seldom described in studies of refractory paediatric glaucoma. 32,[42][43][44] Risk factors for failure after AVI were not evident in our study. Qualified success rates of AVI at last follow-up were not significantly different between subgroups of specific glaucoma diagnosis, age at the time of surgery, presence of previous glaucoma surgery, or combined surgical procedures.…”

Section: Discussionmentioning

confidence: 75%

Clinical outcomes after Ahmed valve implantation in refractory paediatric glaucoma

Yang

Park

2008

Eye

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Purpose To evaluate clinical outcomes after Ahmed valve implantation in refractory paediatric glaucoma. Methods A retrospective review was conducted on 34 eyes from 29 patients with refractory glaucoma, who were younger than 18 years of age and who underwent Ahmed valve implantation. The main outcome measures were intraocular pressures (IOPs) and the number of glaucoma medications used. Qualified success was defined as IOP p21 mm Hg regardless of the number of glaucoma medications. Complete success was defined as IOP p21 mm Hg without glaucoma medication.Results Mean age at operation was 5.5 years (range, 0-16). Fifteen eyes (44.1%) had undergone previous glaucoma surgery before Ahmed valve implantation. Mean follow-up time was 29.1 months (range, 3-31). IOP was reduced from a preoperative mean of 37.5 ± 7.3 to 18.4 ± 7.3 mm Hg at 6 months postoperatively (Po0.01). At 12 months after surgery, the success rates were 63.3% (qualified success) and 13.3% (complete success). The cumulative probabilities of qualified success at 6, 12, and 24 months after Ahmed valve implantation were 89.0, 68.6, and 45.7%, respectively. The median time of survival was 19.6 ± 0.9 months. Conclusions Ahmed valve implantation is effective in lowering IOP in refractory paediatric glaucoma, with limited survival after long-term follow-up. Addition of a second Ahmed valve may be effective in the management of failure after primary implantation.

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“…At least 20% of eyes will be on glaucoma medications 5 years after trabeculectomy to maintain satisfactory IOP control. 7 The surgical alternatives include subconjunctival needle revision, [8][9][10][11][12][13] repeat trabeculectomy, [14][15][16][17][18] and glaucoma drainage devices, [19][20][21] usually with adjunctive wound-healing modifying agents like 5-fluorouracil (5-FU) or mitomycin C (MMC). Another possible surgical option is to reopen the scleral flap and excise fibrotic subconjunctival tissues.…”

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confidence: 99%