Comparative outcome analysis of bleb needling of fibrotic blebs in the clinic versus the operating room: a retrospective case series

BMC Ophthalmology

Vikram Ponnusamy¹  Jella A. An²  Van Nguyen² 

[1] University of Missouri School of Medicine, Columbia, MO, USA;University of Missouri School of Medicine, Columbia, MO, USA;Department of Ophthalmology, Mason Eye Institute, University of Missouri Health Care, 1 Hospital Drive, 65201, Columbia, MO, USA;

关键词: Trabeculectomy;    ExPress shunt;    XEN gel stent;    Bleb needling;    Bleb revision;   

DOI  :  10.1186/s12886-021-01870-1

来源: Springer

【 摘 要 】

BackgroundTo compare 6 month outcomes of bleb needling performed in the clinic vs. the operating room (OR) in adult glaucoma patients with failed bleb.MethodsA retrospective case series of 47 eyes from 41 glaucoma patients who received needling with mitomycin C (MMC) of scarred bleb from prior bleb-forming procedures in clinic (32 eyes) vs. the OR (15 eyes), including trabeculectomy (14 eyes), ExPress shunt (16 eyes), and ab-interno XEN gel stent (17 eyes). The primary outcome was needling success, defined as IOP ≤ 18 mmHg on 0 glaucoma medications without requiring an additional IOP lowering procedure within 6 months after needling.ResultsAt 6 months, bleb needling success rate was similar when performed in the clinic vs. in the OR (28% vs. 20%, P = 0.54). Success rate was not statistically different in patients with prior trabeculectomy, ExPress shunt, and XEN gel stent (29% vs. 38% vs. 12%, P = 0.26). When comparing clinic vs. the OR needling procedures at 6 months, there was no difference in mean IOP (14.2 vs. 14.9 mmHg, P = 0.73), mean glaucoma medications (1.4 vs. 1.7, P = 0.69), additional IOP-lowering procedure rate (16% vs. 27%, P = 0.37), or complication rate (0% vs. 7%, P = 0.32).ConclusionBleb needling with MMC in clinic may be a safe and effective way to revise failed bleb after trabeculectomy, ExPress shunt, and XEN gel stent procedures when compared to needling in the OR.

【 授权许可】

CC BY