Clinical observation of needle revision and 5-fluorouracil subconjunctive injection for the dysfunctional filtering blebs

AIM:To investigate the efficacy and safety of needle revision with 5-fluorouracil(5-FU)on the dysfunctional filtering blebs after trabeculectomy and to assess the factors that may impact the success. <p>METHODS:Eighty-three eyes in 76 patients underwent the needle revision and 5-FU subconjunctive injection for the dysfunctional blebs after trabeculectomy and were followed up for 12mo. The intraocular pressure(IOP), the number of drugs, corneal endothclium, bleb morphology and complications were observed and recorded. <p>RESULTS:IOP decreased significantly from 35.3±5.8mmHg(1kPa=7.5mmHg)of pre-needling to 17.0±4.3mmHg of post-needling(<i>P</i><0.01); the average numbers of medications decreased significantly from 1.7±0.9 of pre-needing to 0.4±0.7 of post-needing(<i>P</i><0.01). At 12mo after needling, the success rate of filtering blebs was 89.2% and the complete success rate was 69.9%.The Kaplan-Meier survival analysis estimated mean survival period was 11.0mo(95%<i>CI</i>: 10.3-11.6). Statistically, there were no significant difference on needling effect with reference to the types of glaucoma, the use of mitomycin C(MMC)during the previous filtration surgery, the ages of patients, the intervals of needling operation from previous trabeculectomy, while there were significant difference on needling effect with reference to bleb appearance before needling, and the mean number of needling in patients that had surgery within 3mo were less than those who had surgery for more than 3mo. <p>CONCLUSION: The needle revision combined with 5-FU is a safe, effective and simple method. Dysfunctional blebs should be treated early after trabeculectomy