Needle Revision of Filtration Blebs

2018 ◽  
Vol 3 (1) ◽  
pp. 229-242 ◽  
Author(s):  
Alfred M. Solish
Keyword(s):  
Needle Revision

scholarly journals Office-based slit-lamp needle revision with adjunctive Mitomycin-C for late failed or encapsulated filtering blebs

2012 ◽  
Vol 19 (2) ◽  
pp. 216 ◽  
Author(s):  
Ramin Daneshvar ◽  
Alireza Esmaili ◽  
Reza Zarei ◽  
Heidar Amini ◽  
Nima Amini
Keyword(s):  
Mitomycin C ◽  
Slit Lamp ◽  
Needle Revision

scholarly journals Development of an Infrared Monitor-Guided Bleb Revision Procedure

2020 ◽  
Vol 11 (2) ◽  
pp. 234-241
Author(s):  
Kenji Matsushita ◽  
Rumi Kawashima ◽  
Kohji Nishida
Keyword(s):  
Intraocular Pressure ◽  
Surgical Procedure ◽  
Pressure Control ◽  
Infrared Light ◽  
Scleral Flap ◽  
Current Case ◽  
Revision Procedure ◽  
Fibrotic Tissue ◽  
Needle Revision

The needle revision procedure to address failing filtering blebs is a blind technique that might easily damage the scleral flap, conjunctiva, and choroid. We propose a new surgical procedure, infrared monitor-guided bleb revision, to perform bleb revision minimally invasively and effectively, and demonstrate the procedure in a patient. We developed the guided procedure with the infrared monitor to observe the bleb interior with greater contrast. Under the monitor, we dissect the hard fibrotic tissue with a bleb knife and, if necessary, remove adhesions using a needle and vitreous forceps. Finally, 5-fluorouracil is injected into the subconjunctiva. We have performed bleb revisions safely with clear visualization of the scleral flap using an infrared light. In the current case, the patient had good intraocular pressure control for about 1 year. The new infrared monitor-guided bleb revision procedure facilitates successful bleb revisions without damage to the underlying structures.

Needle Revision With 5-fluorouracil for the Treatment of Ahmed Glaucoma Valve Filtering Blebs

2016 ◽  
Vol 25 (4) ◽  
pp. e367-e371 ◽  
Author(s):  
Luciano Quaranta ◽  
Irene Floriani ◽  
Lital Hollander ◽  
Davide Poli ◽  
Andreas Katsanos ◽  
...  
Keyword(s):  
Ahmed Glaucoma Valve ◽  
Needle Revision

Use of Ultrasound Biomicroscopy to Predict Long-Term Outcome of Sub-Tenon Needle Revision of Failed Trabeculectomy Blebs: A Pilot Study

2011 ◽  
Vol 21 (6) ◽  
pp. 700-707 ◽  
Author(s):  
Sushmita Kaushik ◽  
Anamika Tiwari ◽  
Surinder Singh Pandav ◽  
Parul Ichhpujani ◽  
Amod Gupta
Keyword(s):  
Ultrasound Biomicroscopy ◽  
Successful Outcome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Successful Group ◽  
Aqueous Flow ◽  
Needle Revision

Purpose. To evaluate the role of ultrasound biomicroscopy (UBM) in predicting the long-term outcome of sub-Tenon needling revision of failed trabeculectomy blebs. Methods. Adult patients with a failed trabeculectomy bleb and unsatisfactory intraocular pressure (IOP) control were recruited. The aqueous flow under the partial thickness scleral flap was looked for and the blebs classified on UBM as scleral route patent (SRP) or scleral route occluded (SRO). All blebs underwent needling revision with injection of 5 mg/0.1 mL 5-fluorouracil. Survival of the revision procedure at the end of 2 years follow-up with regards to the baseline UBM characterization of the bleb was noted. Successful outcome was defined as IOP <22.0 mmHg and/or 30% reduction of baseline IOP with or without medication. Results. A total of 13 eyes had SRP and 5 eyes had SRO blebs on UBM. Only SRP blebs survived the needling procedure by the end of 2 years. Of the 13 SRP blebs, 10 blebs survived (76.9%). Needling had failed in all 5 SRO blebs. The overall success rate was 55.6 % at 2 years. There was no difference in age, IOP, and time from initial trabeculectomy between the failed and successful group. The outcome correlated significantly to the patency of the scleral route assessed by UBM (p=0.07). Conclusions. Ultrasound biomicroscopy characterization of failed blebs appears to help in predicting the outcome of needle revision. In SRO blebs, it may be better to plan a full bleb revision rather than needling alone. Ultrasound biomicroscopy may help in avoiding an unnecessary needling procedure in SRO blebs where it is likely to fail.

Comparison of Efficacy and Safety of Bleb Needle Revision With and Without 5-Fluorouracil for Failing Trabeculectomy Bleb

2019 ◽  
Vol 28 (5) ◽  
pp. 386-391 ◽  
Author(s):  
Jin-Soo Kim ◽  
Hae Jin Kim ◽  
Kyeong Ik Na ◽  
Young Kook Kim ◽  
Ki Ho Park ◽  
...  
Keyword(s):  
Efficacy And Safety ◽  
Needle Revision
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