Dr.Kirti Singh, K04958
Aim
To report outcomes of needling revision for failing glaucoma filters
Method
Bleb needling augmented with 5-Flurouracil was done in 28eyes with internal bleb revision(unplugging blocked sclerostomy)in 9eyes.Bleb age taken as:Early(≤3months),Intermediate(4-12mo) and late(>1yr). Over a min. 3month FU outcomes measured were IOP & anterior segment(AS)OCT in few.
Results
Patients were aged 45±18 years had documented diagnosis pre filter in 25(50% angle closure>18% open angle>22% secondary).Bleb maturity was early in 5, intermediate in 8 and late in 15 patients with oldest bleb being 7years.
Success in terms of IOP reduction was 27±6%(median drop of 10.5mmHg) with max reduction in early group(37.6%).3cases required re-surgery.
Self-limiting complications included subconjunctival haemorrhage and hyphema.AS-OCT documented improved microcystic spaces in bleb in successful cases
Conclusion
Needling revision is effective,safe method to revive failing blebs with success higher in early blebs
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