Bleb Needling with Mitomycin C as Adjunctive Therapy in Failing Blebs: A Retrospective Study

Abstract

Purpose: To evaluate the effects and complications related to use of mitomycin C (MMC) as an adjunctive therapy in bleb needling.

Methods: Retrospective review of the records of patients affected by open-angle glaucoma who underwent a bleb revision as a treatment for failed trabeculectomy. All subjects underwent surgery with a fornix-based approach to incision. Full baseline data for each patient included a comprehensive ocular and medical history, the patient's Snellen visual acuity test results, and Goldmann applanation tonometry test results. Data were reported following observations occurring at 6, 12, 18, 24, and 30 months. In addition, the number and timing of needling with or without MMC subconjunctival injections and any short- and long-term complications were observed.

Results: We included 101 patients, 56 (55.4%) male and 45 (44.6%) female. The mean age was 69.81 ± 16.19 years (range 28-92). Statistically significant effects of needling and needling and MMC (p values <0.05) in the decrease in intraocular pressure were observed. Three (2.9%) patients presented hypotony at the last follow-up visit. No other complications were observed.

Conclusions: Needling bleb revision augmented with the use of MMC appears to be a more useful tool in the management of failing bleb.

Keywords: Bleb needling; Intraocular pressure; Mitomycin C; Trabeculectomy.