J Korean Ophthalmol Soc.  2008 Jun;49(6):951-957. 10.3341/jkos.2008.49.6.951.

Effect of Needle Revision of Failed Filtering Blebs with Different Concentrations of Mitomycin C

• Woo KJ
• Hyung S

• KMID: 2110876
• DOI: http://doi.org/10.3341/jkos.2008.49.6.951

Abstract

PURPOSE: To investigate the efficacy and the risk factors for failure and complications of mitomycin C (MMC)-augmented needle revision (NR) of failed filtering blebs.
METHODS
Thirty eyes whose intraocular pressure (IOP) did not decrease after the cutting of scleral flap sutures were recruited. NR was performed with a 26-gauge needle under a slit-lamp. Immediately following NR, all eyes received a subconjunctival injection of 0.1 ml of 0.02 mg/ml (group A) or 0.1 mg/ml (group B) MMC at the adjacent conjunctiva. The mean follow-up period after the last needle revision was 13.2+/-4.2 months.
RESULTS
The mean IOP decreased from 25.7+/-10.6 mmHg before surgery to 13.7+/-2.5 mmHg at the last follow-up in group A and from 24.1+/-6.8 mmHg to 17.7+/-8.6 mmHg in group B (group A: p=0.001, group B: p=0.065). Subconjunctival hemorrhage, hyphema, and a shallow anterior chamber appeared in most cases. However, choridal detachment and avascular changes of the conjunctiva were observed in group B.
CONCLUSIONS
IOP decreased in both groups A and B, but severe complications appeared only in group B. NR followed by a subconjunctival injection of 0.02 rather than 0.1 mg/ml is a safe and effective method.

Keyword

Filtering bleb; Mitomycin C; Needle revision

MeSH Terms

Anterior Chamber
Blister
Conjunctiva
Eye
Follow-Up Studies
Hemorrhage
Hyphema
Intraocular Pressure
Mitomycin
Needles
Risk Factors
Sutures
Mitomycin

Figure

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  Figure 1. Pre‐ NR and post‐ NR intraocular pressure.* NR with 0.02 mg/ml MMC; † NR with 0.1 mg/ml MMC; ‡ Needle revision.

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  Figure 2. Comparisons of cumulative success rate between Group A and Group B (Kaplan‐ Meier survival curve).* Intraocular pressure lesser than 18 mmHg regardless of glaucoma medications; † NR with 0.02 mg/ml MMC; ‡ NR with 0.1 mg/ml MMC.

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