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Long-term outcomes of needle revision of failing deep sclerectomy blebs

Poster Details

First Author: A.Koukkoulli UK

Co Author(s):    N. Anand              

Abstract Details



Purpose:

To report long-term outcomes for Mitomycin C (MMC)- augmented Needle Revision (NR) of failing Deep Sclerectomy (DS).

Setting:

Calderdale & Huddersfield NHS Trust, West Yorkshire, UK

Methods:

Retrospective database search of all needle revisions with MMC for DS at our centre between 2002 and 2008. 66 eyes of 66 patients were included in study. Subconjunctival MMC 0.01- 0.02 mg was injected 15 minutes before the NR. Complete success was defined as an IOP ? 18mmHg and a 20% decrease from baseline with no glaucoma medications or further surgical procedures to lower IOP. Partial success was the same but with medications.

Results:

Mean follow-up after the index NR was 67.8 ±24.8 months (range 1-10 years). The mean number of needle revisions was 1.6 ±0.8 (range 1-4). Two or more procedures were done in 31 eyes (47.0%). Mean preoperative IOP was 23.2 ±6.9 mmHg. Complete and partial success rates were 64% and 71% at one year, 57% and 68% at three years and 40% and 58% at 5 years after surgery respectively. By last follow-up 39 eyes (59.1%) were deemed to have failed by the complete success criteria. Early NR, within 6 months of index surgery was significantly associated with failure by both uni- and multivariate tests. Significant complications included delayed hypotony in 5 eyes (7.6%), delayed bleb leak in 2 (3.0%), endophthalmitis in 1 eyes (1.5%) and corneal edema in 2 eyes (3.0%).

Conclusions:

NR with subconjunctival MMC may successfully lower the IOP in eyes with a failing DS in the longterm but with significant complications.

Financial Disclosure:

NONE

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