VT58 : Needle revision of failed filtering bleb with high dose of injectable Mitomycin-C”.

Dr.Devendra Maheshwari, Dr.SHYLESH DABKE, Dr.Aditi Nair, Dr.Mohideen Abdul Kadar Pmt

Trabeculectomy surgery involves creating subconjunctival filtration channel in treatment of chronic glaucoma. Since its first description, the operation has survived challenges from newer procedures. This surgery, however, is not without its pitfalls as the bleb is known to remodel indefinitely. Subconjunctival fibrosis, being the most common cause of failure. In an attempt to control the fibrotic response mitomycin C have been used. Thus, increasing IOP with failing blebs continues to be an issue after trabecuectomy. Options at the disposal include reintroduction of antiglaucoma medications or re-do filtration surgery or needling of the bleb. Needling of the bleb helps to cut through the fibrous tissue with a needle, which engulfs the bleb and leads to failure; antifibrotics are used as an adjuvant to prevent or retard closure by decreasing the production of fibroblasts and scar tissue. In this video we demonstrate 5 cases of bleb needling under different case scenario.