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VOLUME 40 , ISSUE 6ENG ( Dec-2012, 2012 ) > List of Articles

REVIEW ARTICLE

Management of Bleb Failure with 5-Fluorouracil Augmented Bleb Needling and Sub-Bleb Healon-5 Injection

Amr Khafagy, Hany Elmekawey

Citation Information : Khafagy A, Elmekawey H. Management of Bleb Failure with 5-Fluorouracil Augmented Bleb Needling and Sub-Bleb Healon-5 Injection. 2012; 40 (6ENG):8-12.

DOI: 10.5005/hoo-10101-40602

Published Online: 25-12-2012

Copyright Statement:  Copyright © 2012; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Purpose: To evaluate the efficacy and the safety of 5-fluorouracil augmented bleb needling revision with sub-bleb Healon-5 injection for patients with failing filtering bleb. Methods: This is a prospective study which included 18 eyes of 16 patients, who had 5-fluorouracil augmented bleb needling revision with sub-bleb Healon-5 injection for failing filtering bleb (uncontrolled IOP above 21 mmHg) despite the usage of anti-glaucoma medications, between August 2010 and May 2011 at the Ophthalmology Department, Cairo University Hospital. All patients were followed up for 6 months. Results: The mean preoperative intraocular pressure was (28.83+2.53 mmHg) and decreased to (17.83+4.27 mmHg) at the end of follow-up period. Ten eyes (56%) achieved absolute success, had intraocular pressure between 10 and 21 mmHg without further needling revision or topical anti-glaucoma medications during the follow- up. 5 eyes (28%) achieved a qualified success, had intraocular pressure with the same above range but with topical anti-glaucoma medications during the follow-up period. Failure occurred in three eyes (5.5%), needing further surgical intervention. Conclusion: 5-fluorouracil augmented bleb needling revision with sub-bleb Healon-5 injection is an effective and simple technique in controlling the intraocular pressure in eyes with failing filtering bleb. It also avoids the need for further surgical intervention in the majority of patients and has a low incidence of complications.


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