Needle Revision on Failed Filtering Blebs Using Mitomycin C

PURPOSE: To determine the success rate and complications of Mitomycin C (MMC) augmented needle revision on failed filtering blebs. METHODS: We retrospectively investigated the records of 30 patients (32 eyes) who had undergone needle revision with MMC on failed filtering blebs. A mixture of 0.02 ml of MMC (0.4 mg/ml) and 0.02 ml of 2% lidocaine (20 mg/ml) was injected subconjunctivally. 5 minutes later, needle revision was done with bented 30 gauge needle. RESULTS: The mean Intraocular pressure(IOP) decreased from 28.1+/-9.4 mm Hg before surgery to 14.7+/-6.2 mmHg at the last follow-up. The mean follow-up period after the last needle revision was 23.5+/-19.4 months. In 27 eyes (84.4%), the last IOP was less than or equal to 18 mmHg. Serious complications were not found. CONCLUSIONS: MMC augmented needle revision appears to be an effective way to revive failed filtration blebs. The incidence of complications compares favorably to that of other glaucoma related surgery.

Outcome of Mini Monoka Silicone Monocanalicular Lacrimal Stents in Canalicular Laceration

PURPOSE: To determine clinical outcomes of mini Monoka silicone monocanalicular lacrimal stent (from now, mini Monoka stent) in canalicular injury. METHODS: From June 1996 to December 2001, mini Monoka stent was used in 70 eyes(77 canaliculi) of superior, inferior and bicanalicular injury. Mini Monoka stent was shortened about 20 mm with round tip and intubated. Punctal fixation suture was not done. RESULTS: The mean follow-up period was 7.9+/-1.0 months (4-12 months). The outcome of our repair was judged by the existence of epiphora, dye disappearance test, probing and irrigation. In 57 eyes (81.4%), there was no epiphora. In 11 eyes (15.7%), epiphora was developed only after certain stimuli. In 2 eyes (2.9%), there was epiphora at all times. Postoperative complications were premature stent loss 6 eyes (8.6%), conjunctival injection 3 eyes (3.9%). CONCLUSIONS: The intubation of mini Monoka stent for the lacerated canaliculus is the simply operative procedure in the outpatient department. The shortening of mini Monoka stent made this procedure easier. Despite no punctal fixation suture, the occurrence rate of the premature stent loss was not higher than that for published reports of mini Monoka stent.