| Past Issue | Volume 9, Number 1, February 2007 | | Needling Bleb Revision with Mitomycin C for Failed Molteno Tube Shunt Implant |
Reza Zarei, Saeid Shahhosseini
Farabi Eye Research Center, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
Aim: Needling bleb revision with mitomycin C is an accepted method of management of failed trabeculectomy with encapsulated bleb. We report the outcome of the needling bleb revision with mitomycin C in poorly functioning filtering blebs associated with the Molteno drainage device.
Methods: Sixteen eyes of 16 patients with encapsulated bleb around the Molteno plate and elevated intraocular pressure not controlled by medical management, underwent bleb revision with mitomycin C.
Results: There were 16 eyes of 16 patients aged 5 to 65 years (mean, 28.8 ± 22.7 years). Six patients were female and 10 patients were male. Aphakia and congenital glaucoma were the most common aetiologies. The mean period of follow-up was 24 months and the duration between surgery and needling was 18.25 ± 12.10 months. Mean intraocular pressure was reduced from 28.25 ± 3.70 mm Hg preoperatively to 16.69 ± 3.14 mm Hg at 3 months and 21.13 ± 4.11 mm Hg at 6 months of follow-up. The success rate was 87.5% at 3 months, 37.5% at 6 months, and 12.5% after 2 years of follow-up.
Conclusions: Needling bleb revision with mitomycin C is a relatively safe and effective method in the management of failed encapsulated Molteno tube implant. Although its effectiveness may be limited, it is a repeatable procedure.
Key words: Glaucoma, Mitomycin, Molteno implants, Prosthesis failure, Trabulectomy
Asian J Ophthalmol. 2007;9:27-29.
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