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First Author: N.Anand UK
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To report outcomes of needle revision of trabeculectomy blebs with subconjunctival Bevacizumab.
Calderdale & Huddersfield NHS Trust, West Yorkshire , UK
Retrospective case- series of eyes undergoing needle revision (NR) with adjunctive subconjunctival Bevacizumab.( 2.5mg in 0.1 ml). All procedures were performed 6 months after trabeculectomy by the same surgeon. Success was defined as an IOP ?18 mmHg and a 20% decrease from baseline IOP with no medications.
15 eyes of 14 patients were included. The interval between trabeculectomy and NR was 58.5 ±52.9 (range 7-156) months. Mean follow-up after NR was 22.1 ±8.6 (range 12-36) months. Mean IOP at decision to perform NR was 23.0 ±5.0 mmHg. Success by last follow-up was achieved in 9 eyes (60%). Kaplan-Meir success rates were 57.1 % (36.3 89.9%, 95% Confidence Intervals) at one year and 40.8% (21.3-78.4, 95% CIs) at 2 years after NR. At last follow-up 4 (26.7%) eyes needed medications to control IOP. Subsequent procedures to control IOP were selective laser trabeculoplasty in 2 eyes and trabeculectomy with MMC and NR with MMC in 1 eye each. One eye each had a shallow anterior chamber and hyphema in the first week after NR.
NR with subconjunctival Bevacizumab was safe and effective in lowering IOP in majority of eyes in with delayed trabeculectomy failure.