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R. Suzuki, R.M. Vessani, R. Susanna, Jr.; Transconjunctival Needling Revision With 5–Fluorouracil Versus Medical Treatment in Encapsulated Blebs: A 6 Month Prospective Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):18.
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To compare the efficacy and safety of transconjuctival needling revision with 5–fluorouracil (TNR) and medical treatment in glaucomatous eye with encapsulated bleb (tenon’s cyst) after trabeculectomy
Prospective and consecutive study of glaucomatous eyes submitted to trabeculectomy that developed encapsulated blebs with intra ocular pressure (IOP) ≥ 20mmHg. Eyes were randomized to either TNR or medical treatment. All eyes were followed up for at least 6 months. A maximum of two TNR was allowed in the study. Failure of treatment was defined as intra ocular pressure ≥ 18mmHg.
39 eyes were included in the study. 20 eyes were submitted to TNR. 3 eyes required a second needling revision. 19 eyes were treated with medication. There was no significant difference in mean IOP before treatment, sex and race between groups. After 6 months treatment failure was observed in 6 eyes of the group submitted to TNR and in 7 eyes of the group submitted to clinical therapy (p=0.83). Mean IOP in eyes submitted to TNR was 11.8 mmHg and 14.6 mmHg in eyes treated with medication. This difference was significant (p=0.0027). Complication were observed in 2 eyes submitted to TNR (1 eye with grade III flat anterior chamber and coroidal detachment and 1 eye with grade III flat anterior chamber and hyfema).
Mean intra ocular pressure is lower after TNR comparing with medical treatment after 6 months follow–up. However, in this study no significant difference in treatment failure was observed between the two groups.
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