Needling revision with marking maneuver to locate the scleral flap

Abstract

Purpose: To report a variation of the classical needle revision maneuver with an external marking of the scleral flap, augmented with mitomycin C (MMC) in failed non penetrating deep sclerectomy (NPDS).

Method: This observational prospective pilot study included five consecutive patients who underwent an MMC needling revision of failed NPDS with the external marking of the scleral flap. All participants underwent a complete ophthalmologic examination and data were collected preoperatively as well as 1 day, 1 week and 1 month after the surgery. The surgical site was also evaluated during the procedure.

Results: A significant reduction of IOP and antiglaucomatous medication from preoperative levels was detected at the end of the follow-up period. Regarding the surgical site, we succeed in locating the scleral flap and observing the bleb formation in all cases. No significant subconjunctival bleeding was detected.

Conclusion: This variation of the classical needling technique seems to improve intrasurgical visualization and reduces complications, which might lead to an improvement in surgical success.

Keywords: Aqueous humor dynamics; GLAUCOMA; anti-fibrotic agents; epidemiology/risk factors; glaucoma incisional surgery; open angle glaucoma.