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First Author: A.Koukkoulli UK
Co Author(s): N. Anand
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To report long-term outcomes for Mitomycin C (MMC)- augmented Needle Revision (NR) of failing Deep Sclerectomy (DS).
Calderdale & Huddersfield NHS Trust, West Yorkshire, UK
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.
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%).
NR with subconjunctival MMC may successfully lower the IOP in eyes with a failing DS in the longterm but with significant complications.