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Trabeculectomy bleb needling and antimetabolite administration practices in the UK: a glaucoma specialist national survey

Poster Details

First Author: B.Drury UK

Co Author(s):    K. Mercieca   A. Bhargava   C. Fenerty              

Abstract Details


To evaluate, describe and quantify the diversity in post-operative antimetabolite administration and bleb needling practices amongst glaucoma specialists performing trabeculectomy surgery within the U.K. and Ireland.


Manchester Royal Eye Hospital, Machester and Royal Preston Hospital, Preston


A cross-sectional online survey was distributed to all consultant glaucoma specialists who are on the United Kingdom & Eire Glaucoma Society (UKEGS) contact list. Participants were asked specific questions about their current practices for post-trabeculectomy antimetabolite administration followed by questions directly related to bleb needling procedures.


60 consultants completed the survey. Doses of 5-FU varied considerably but 70% used 5mg as standard. Techniques used to reduce corneal toxicity included precipitation with amethocaine (44%) or benoxinate (14%), saline wash (14%) and modified injection technique (8%); 42% of participants did not use a specific strategy to prevent this. Bleb needling was exclusively performed in operating theatre by 56% of respondents. Anti-metabolites used were 5-Fluorouracil (72%) and mitomycin C (22%) with 12% using either of the two substances. Only a minority of participants used viscoelastic (32%) or subconjunctival steroid (42%) as part of their needling technique.


There is a significantly wide variety of current practices for antimetabolite administration and bleb needling within the UK and Ireland. This may be influenced by a glaucoma surgeon�â�€�™s specific experience and audit results as well as particular clinical set-up, availability of antimetabolite and clinic room space.

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