ABSTRACT
La trabeculectomía es uno de los tratamientos de elección en los pacientes con glaucoma. La causa más común de fallo de esta cirugía en su primer trimestre es la bula de filtración encapsulada. Usualmente es resultado de la proliferación fibrótica subconjuntival que lleva a fallo de la bula, como por ejemplo en los glaucomas traumáticos. La revisión con agujas y la mitomicina C constituyen una opción efectiva y relativamente segura para restaurar la función de la cirugía de filtración. Se presenta un paciente donde se restableció el flujo de humor acuso con este proceder
Trabeculectomy is the surgical treatment of choice for many patients with glaucoma. The most common cause of failure during the first trimester after trabeculectomy is encapsulated bleb. Generally, that results from scarring in the subconjunctival space with a resultant intrableb fibrosis and the development of a failed bleb, for example in traumatic glaucoma. Needling bleb revision with mitomycin-C appears to be an effective and relatively safe way to revive the function of the filtration surgery. This was the case report of a patient whose aqueous humor flow was reestablished with this treatment
ABSTRACT
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.
Subject(s)
Humans , Blister , Filtration , Follow-Up Studies , Glaucoma , Incidence , Lidocaine , Mitomycin , Needles , Retrospective StudiesABSTRACT
PURPOSE: The purpose of the study is to determine the efficacy and safety of needle revision of failed filtering blebs using preoperative mitomycin C (MMC) application. METHODS: We reviewed the records of 28 patients (31 eyes) who had undergone needle revision with MMC for the treatment of failed filtering bleb. MMC (0.02 mg/ml, 0.1 ml) was injected subconjunctivally one day before needle revision. RESULTS: Postopertive mean follow-up period was 42 weeks. Twenty five eyes (80.6%) were classified as surgical success which was defined as IOP less than 21 mmHg with or without any antiglaucomatous therapy. Intraocular pressure decreased from 25.5+/-6.0 mmHg before surgery to 18.6+/-5.2 mmHg at the last follow-up (p< 0.05). No serious complication was found. CONCLUSION: Our result suggested that needle revision with the preoperative subconjunctival injetion of mitomycin-C may be an effective and safe method to revive failed filtration blebs.