Effectiveness of Needling Revision with Mitomycin-C for Failing Blebs
|Sylvia L. Groth1* and William Eric Sponsel2|
|1University of Minnesota Medical School, Minneapolis, MN, USA|
|2Baptist Medical Center, San Antonio, TX, USA|
|Corresponding Author :||Sylvia L. Groth, B.A.
University of Minnesota Medical School
4625 Portland Ave, Minneapolis
MN, 55407, USA
Tel: 760 207 2778
E-mail: [email protected]
|Received October 17, 2011; Accepted January 31, 2012; Published February 03, 2012|
|Citation: Groth SL, Sponsel WE (2012) Effectiveness of Needling Revision with Mitomycin-C for Failing Blebs. J Clinic Experiment Ophthalmol S4:006. doi:10.4172/2155-9570.S4-006|
|Copyright: © 2012 Groth SL, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
|Related article at
Pubmed Scholar Google
This surgical technique study was designed to evaluate the efficacy of surgical needling revision using Mitomycin-C to restore filtering function in scarred or encapsulated filtering blebs, and thereby minimize reliance on adjunctive medications. Twenty-eight eyes of 23 consecutive patients were studied, all having undergone operating room based bleb revisions for inadequate IOP-control during 2008-10. The standard needling procedure was performed as described with our previous data set, now using a 1-minute intra-bleb cannulation of 0.6 ml of 0.4 mg/ml MMC rather than multiple postoperative subconjunctival 5-fluorouracil injections. Outcome measures were IOP, number of antiglaucoma medications, and acuity. Both mean IOP reduction and decrease in anti-glaucoma medications at all four measured time intervals (1 week, 1 month, 2 months, 6 months) post-operatively were highly significant (p<0.0001). IOP was reduced from a mean of 27.2 ± 10.6 mmHg pre-op to 15 ± 7.8 mmHg 6 months post-op (Δ -45%), with 86% of eyes requiring glaucoma medication prior to the procedure and only 16% thereafter. At six months, 60% of eyes had IOP ≤15 mmHg without medications, and 76% ≤18 mmHg. Visual acuity was stable or improved in 69% of cases. Mitomycin-C augmented needling revision appears to be a reasonably safe and reliable option for restoring bleb function in glaucomatous eyes with failed filters.