Needle Revision with Antimetabolites in Bleb Failure

• Main Author: Ehab Ghoneim (Author)
• Format: Book
• Published: Journal of Clinical Research and Ophthalmology - Peertechz Publications, 2014-12-12.
• Subjects: Mini Review
• Online Access: Connect to this object online.

<p>Glaucoma filtering surgery is unusual in that its goal is the creation and maintenance of a non healing fistula between two anatomic spaces that are normally not connected [1]. <br></p><p>Fibroblasts, connective tissue elements, cytokines, aqueous humor and the surrounding vascular supply all influence what happens to a bleb over a long period of time.</p><p>The enemy of drainage procedure is excessive scarring [2]. <br></p><p>Long-term studies showed a loss of intraocular pressure (IOP) control in a significant proportion of eyes with an initially successful trabeculectomy [2,3]. So follow up of glaucoma patients after surgery is mandatory as significant proportion develop bleb failure.</p><p>Revision of guarded filtration procedures was reported as early as 1941 by Ferrer [4]. Needling as currently performed was described by Pederson and Smith [5]. The combination of needling with antimetabolites (mitomycin C and 5FU) greatly improve the outcome of needling and enhance bleb survival.</p>