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Objective: To study the outcome of subconjunctival needling with 5-fluorouracil in filtration blebs in the patients who have been treated by trabeculectomy.
Methods: Retrospective chart review of glaucoma patients who have been treated by trabeculectomy or combined phaco-trabeculectomy, and needling revision in accordance to indications at Thammasart University Hospital from January 2015 to December 2017 in total of 52 eyes. The treatment result was monitored during a 6 month- period. Success outcome by monitoring IOP and factors affecting failure of procedure are outcome measurement. In needling procedure, 27-gauge needle and 0.1 mL of 50 mg/mL of 5-FU were used.
Results: After needle revision, mean IOP decreased from 20.5±6.77 mmHg to 13.35±8.11 mmHg at 6 months (p<0.001), median IOP reduction was 29.70%. Complete success, qualified success and failure were at 63.46%, 19.23%, 17.31%, respectively. Incidence rate of failure was 7.92, using Kaplan-Meier survival analysis. Risk factors for failure of 5-FU needling were pre-needling IOP ≥ 25 mmHg (HR 3.81, p=0.047) and secondary
glaucoma including NVG (HR=2.6,p=0.154). In addition, serious complication was not detected after monitoring of treatment for 6 full months.
Conclusion: Bleb needle revision could reduce IOP in the patients who failed filtering bleb and could restore function of bleb in the patients with increasing trends in IOP from bleb morphology which is at safe and effective procedure.
Conflicts of interest: The authors report no conflicts of interest.
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