The efficacy of bleb needling revision with 5-fluorouracil in encapsulated bleb after unsuccessful trabeculectomy

Abstract

Objectives: To investigate the efficacy of the bleb needling revision (BNR) procedure with the adjunctive useof 5-Fluorouracil (5-FU) in encapsulated bleb after unsuccessful trabeculectomy.Methods: We reviewed 16 eyes of 15 subjects who underwent BNR procedure due to encapsulated bleb afterunsuccessful trabeculectomy. Demographic data, type of glaucoma, intraocular pressure (IOP) values of preBNR, IOP values of post-BNR at first day, first week and first month, follow up time and complications wererecorded from patients’ files, retrospectively.Results: The mean follow up time was 53.1 ± 26.4 weeks. The average time between previous unsuccessfultrabeculectomy and BNR was 11.12 ± 8.79 weeks. The mean IOP of pre-BNR was 26.0±4.4 mmHg andsignificantly decreased to 12.4 ± 5.0 mmHg post-BNR at the first day (p < 0.001). The mean IOP values ofpost-BNR at the first week was 13.3 ± 4.9 mmHg and at the first month was 14.8 ± 4.8 mmHg. According tothe mean IOP of pre-BNR, the mean IOP values of post-BNR at the first week and at the first month weresignificantly lower (p < 0.001 and p < 0.001, respectively). Seven (44%) eyes were achieved success and eight(50%) eyes were achieved qualified success. One (6%) eye was classified as the failure.Conclusion: The bleb needling revision procedure with the adjunctive use of 5-FU in encapsulated bleb afterunsuccessful trabeculectomy is a simple, useful and repeatable method to restore the dysfunctional bleb.