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N. V. Palejwala, G. Fakhraie, A. B. Melo, J. S. Myers, L. J. Katz; Bleb Needling Revision With Cataract Surgery: A Retrospective Comparative Study. Invest. Ophthalmol. Vis. Sci. 2009;50(13):177.
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To assess the long-term results of needle revision of failed filtration blebs and cataract surgery at the same session, and to compare it with a control group of bleb needlings without cataract surgery.
This study is a retrospective, comparative chart review. Medical records of all patients undergoing simultaneous needling of a poorly functioning trabeculectomy bleb and cataract surgery (Study Group) were reviewed. Each member of this group was matched with 2 controls from a group that had bleb needling without cataract surgery (Control Group). Success was defined as intraocular pressure (IOP) < 21 mmHg and IOP < 80% of preneedling IOP, on the same or fewer glaucoma drops and without further glaucoma surgery.
Twenty-five patients in the study group and 50 patients in the control group were included. The mean age was 68.2 ± 9 years in the study group and 74 ± 9.4 years in the control group (P=0.014). The mean IOP at baseline was 25.64 ± 2.61 mm Hg and 26.68 ± 4.57 mm Hg in the study group and control group respectively (P=0.294). This value at final visit was 20.44 ± 5.03 mm Hg in the study group and 14.32 ± 5.01 mm Hg in the control group (P<0.001). The mean number of glaucoma medication at baseline was 2.08 ± 0.86 in the study group and 1.8 ± 1.24 in the control group (P=0.357). At final visit, the mean number of glaucoma medication was 1.44 ± 0.91 in the study group and 0.94 ± 1.15 in the control group (P=0.024). The number of patients without glaucoma medication at last visit was 5 (20%) cases in the study group and 25 (50%) cases in the control group (P=0.012). Success at final follow-up was 9 (36%) cases in the study group and 28 (56%) cases in the control group (P=0.102).
When comparing bleb needling revision combined with cataract surgery with bleb needling revision alone, the former group appears to yield a higher IOP, a greater need for glaucoma medication, and a lower success rate (P=NS) at final follow-up.
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