| International FP-004 |
| Comparison of Efficacy and Safety of Bleb Needle Revision with and without 5-Fluorouracil for Failing Trabeculectomy Bleb |
| Department of Ophthalmology, Seoul National University Hospital(1)
Cheonan Kim’s Eye Clinic, the head office(2)
Department of Ophthalmology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine(3)
Department of Ophthalmology, Seoul National University College of Medicine(4) |
| Jin-Soo Kim(1), Hae Jin Kim(1,2), Kyeong Ik Na(3), Young Kook Kim(1,4), Ki Ho Park(1,4), Jin Wook Jeoung(1,4) |
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Purpose : To investigate the efficacy and safety of bleb needle revision with adjunctive 5-fluorouracil (5-FU) subconjunctival injection in a large-scaled patients with failing trabeculectomy bleb.
Methods : A retrospective chart review was performed on a total of 113 eyes of 106 subjects who had undergone trabeculectomy followed by needle revision and been followed up for at least 6 months. The subjects were divided into two groups according to whether they had also undergone concurrent adjunctive 5-FU subconjunctival injection. Two definitions of failure were derived irrespective of IOP-lowering medication use and were assessed at each follow-up visit: 1) IOP > 21 mmHg or > 85% of preoperative IOP or reoperation for glaucoma, 2) IOP > 18 mmHg or > 80% of preoperative IOP or reoperation for glaucoma.
Results : A total of 78 eyes of 73 subjects underwent the simple needle revision procedure and 35 eyes of 33 subjects underwent needle revision with subconjunctival 5-FU injection. There was no significant adverse event for either group and no significant IOP difference in any of the observational periods between them (P = 0.867). There was also no statistically significant difference in the total number of IOP-lowering medications between the groups (P = 0.199). The success rate at 24 months after the first needle revision was 45.6% (95% PI; 33.7, 56.7) in simple revision group and 44.6% (95% PI; 27.7, 60.2) in 5-FU needle revision group by failure 1, 36.3% (95% PI, 25.4, 47.2) and 32.9% (95% PI; 18.0, 48.6) by failure 2, respectively. A greater total number of needle revisions was the significant risk factors for needle revision failure (HR = 2.25 and P = 0.001 according to failure 2).
Conclusion : Bleb needle revision with 5-FU subconjunctival injection is a safe procedure for failing trabeculectomy bleb. Bleb needle revision with and without 5-FU were equally likely to succeed.
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