ArticleIndian journal of ophthalmology2018
Rescue of failing or failed trabeculectomy blebs with slit-lamp needling and adjunctive mitomycin C in Indian eyes.
Article in Indian journal of ophthalmology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 15 citations in OpenAlex.
- High dose versus low dose Mitomycin-C assisted bleb needling in failing trabeculectomy blebs: a prospective comparative study.International ophthalmology · 2026Trial
- Bleb resuscitation of failing, leaking and dysfunctional blebs: A review.Indian journal of ophthalmology · 2025Review
- Safety and Efficacy of the Rho-Kinase Inhibitor (Ripasudil) in Bleb Needling after Trabeculectomy: A Prospective Multicenter Study.Journal of clinical medicine · 2023Article
- Outcomes of bleb needling in primary glaucoma: A prospective interventional study in a South Indian population.Indian journal of ophthalmology · 2022Article
- Success of Primary Trabeculectomy in Advanced Open Angle Glaucoma.Clinical ophthalmology (Auckland, N.Z.) · 2021Article
- An Ex-Press implant versus trabeculectomy in a fibrotic bleb with late failure after previous trabeculectomy.International journal of ophthalmology · 2021Article
- Safety and Efficacy of Bleb Needling with Antimetabolite after Trabeculectomy Failure in Glaucoma Patients: A Systemic Review and Meta-Analysis.Journal of ophthalmology · 2020Article
- Long-term outcome of mitomycin C-augmented needle revision of trabeculectomy blebs for late trabeculectomy failure.Eye (London, England) · 2018Observational
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this study is to investigate the efficacy and safety of needling-revision augmented with a high dose of mitomycin C (MMC) in failing or failed blebs after trabeculectomy in Indian eyes.
methodsProspective, noncomparative, interventional study. All patients (>18 years) who had raised intraocular pressure (IOP) following trabeculectomy (>6 weeks and <2 years), who had a flat bleb, bleb encapsulation, and/or required antiglaucoma medication (AGM) for IOP control were eligible for inclusion. MMC was injected subconjunctivally at least ½ hour before the needling procedure was carried out at the slit lamp in the outpatient's clinic.
resultsThirty-nine eyes of 38 patients were included. The median follow-up was 20 months and time interval between trabeculectomy and needle revision was 113 days. Initially, in all cases, aqueous flow was re-established with a raised bleb; 7 eyes required repeat needling. IOP decreased from median 24 mmHg (Q1 21, Q3 27, interquartile range [IQR] 6, range 18-35) preneedling to median 14 mmHg (Q1 10, Q3 16, IQR 6, range 6-18) postneedling at last follow-up (P < 0.0001, 95% confidence interval [CI]: 8.2-13.0). The use of AGM reduced from median 1 (Q1 0, Q3 3, IQR 3, range 0-4) preneedling to median 0 postneedling (P < 0.0001, 95% CI: 1-2). Complete success was seen in 28 eyes (71.8%, 95% CI: 71.1%-96.4%); another 5 eyes (12.8%) were controlled with AGM (qualified success) with overall success of 84.6%. Most complications were transient in nature with resolution within 1 week. One patient developed hypotony, and another developed a late bleb leak.
conclusionNeedling revision augmented with high-dose MMC, at the slit lamp, effectively rescues failing or failed filtration, and appears to be safe.
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