April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Long-Term Outcomes of Bleb Needling With Intraoperative Transconjunctival Mitomycin-c Application
Author Affiliations & Notes
  • N. H. Brown
    Medicine, Santa Clara Valley Medical Center, San Jose, California
  • C. Li
    Glaucoma Center of San Francisco, San Francisco, California
  • A. G. Iwach
    Glaucoma Center of San Francisco, San Francisco, California
    Glaucoma Research and Education Group, San Francisco, California
  • J. Shi
    Glaucoma Center of San Francisco, San Francisco, California
  • M. Mata-Plathy
    Glaucoma Center of San Francisco, San Francisco, California
  • T. Pickering
    Glaucoma Center of San Francisco, San Francisco, California
    Glaucoma Research and Education Group, San Francisco, California
  • N. Nguyen
    Glaucoma Research and Education Group, San Francisco, California
  • J. Hetherington
    Glaucoma Research and Education Group, San Francisco, California
  • S. Radhakrishnan
    Glaucoma Center of San Francisco, San Francisco, California
    Glaucoma Research and Education Group, San Francisco, California
  • Footnotes
    Commercial Relationships  N.H. Brown, None; C. Li, None; A.G. Iwach, Ista Pharmaceutical, R; Laserex Systems Inc., R; Pfizer Ophthalmics, R; Clarity, C; Carl Zeiss, R; Alcon, R; Iridex, R; J. Shi, None; M. Mata-Plathy, None; T. Pickering, Alcon, C; N. Nguyen, None; J. Hetherington, None; S. Radhakrishnan, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 599. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      N. H. Brown, C. Li, A. G. Iwach, J. Shi, M. Mata-Plathy, T. Pickering, N. Nguyen, J. Hetherington, S. Radhakrishnan; Long-Term Outcomes of Bleb Needling With Intraoperative Transconjunctival Mitomycin-c Application. Invest. Ophthalmol. Vis. Sci. 2010;51(13):599.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: : To report long-term outcomes of bleb needling with intraoperative transconjunctival mitomycin-C application (ITMA).

Methods: : Retrospective chart review of 119 eyes (119 patients) that underwent needle revision of a failing filtering bleb with ITMA. A 25-G needle was used and the entry site was sutured. This was followed by ITMA (0.5 mg/ml) with sponges kept in contact with the conjunctival epithelium for 6 minutes. Success was defined as ≥30% decrease in IOP with/without medications and no major complications/further surgery.

Results: : Mean age was 67±16 yrs; 55% were female, 68% were Caucasian, 71% had POAG and 60% were pseudophakic. Mean follow-up was 44.2±37.4 months. Baseline IOP of 19.9±5.6 mmHg was reduced by 6.1±3.9 mmHg at the end of follow-up. Average number of medications before and after surgery was 1.8 ±1.2 and 1.1±1.3 (p = 0.0001), respectively. Cumulative probability of success was 87%, 78%, 64% and 61% at 6, 12, 18, and 24 months, respectively. 44/119 eyes (37%) required further IOP lowering surgery. 97 eyes (82%) received post-operative 5-FU injections (average number was 5.1±3.4). Immediate post-op complications included self-limiting hyphema in 5 eyes (4.2%) and choroidal hemorrhage in 2 eyes (1.7%, both underwent choroidal drainage). Late complications included bleb leak in 6 eyes (5%), blebitis in 5 eyes (4.2%) and hypotony in 3 eyes (2.5%); all resolved with conservative management. Cox regression analysis showed significantly longer survival for younger patients (r = 0.97, p<0.001) and those who received 5-FU (r =2.03 and p=0.03). Of those who received 5-FU, the use of ≥ 5 injections improved survival (r=1.92, p=0.04).

Conclusions: : Bleb needling with ITMA and post-operative 5-FU was effective in lowering IOP in the short to intermediate term.

Keywords: injection • wound healing • clinical (human) or epidemiologic studies: outcomes/complications 
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×