Early transconjunctival needling revision with 5-fluorouracil versus medical treatment in encapsulated blebs: a 12-month prospective study

To compare the efficacy of transconjunctival needling revision with 5-fluorouracil versus medical treatment in glaucomatous eyes with uncontrolled intraocular pressure due to encapsulated bleb after trabeculectomy. Prospective, randomized, interventional study. A total of 40 eyes in 39 patients with...

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Published in:Clinics (São Paulo, Brazil) Brazil), 2013-10, Vol.68 (10), p.1376-1379
Main Authors: Suzuki, Ricardo, Susanna-Jr, Remo
Format: Article
Language:English
Subjects:
5-Fluorouracil
Adult
Aged
Aged, 80 and over
Antimetabolites - therapeutic use
Blister - etiology
Blister - therapy
Conjunctiva - drug effects
Conjunctiva - surgery
Encapsulated bleb
Female
Fluorouracil - therapeutic use
Glaucoma
Glaucoma - surgery
Humans
Intraocular Pressure
Male
Medical Treatment
MEDICINE, GENERAL & INTERNAL
Middle Aged
Needles
Needling
Postoperative Complications
Prospective Studies
Rapid Communication
Revision
Statistics, Nonparametric
Time Factors
Trabeculectomy - adverse effects
Treatment Outcome
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Susanna-Jr, Remo
description To compare the efficacy of transconjunctival needling revision with 5-fluorouracil versus medical treatment in glaucomatous eyes with uncontrolled intraocular pressure due to encapsulated bleb after trabeculectomy. Prospective, randomized, interventional study. A total of 40 eyes in 39 patients with elevated intraocular pressure and encapsulated blebs diagnosed at a maximum five months after primary trabeculectomy with mitomycin C were included. The eyes were randomized to either transconjunctival needling revision with 5- fluorouracil or medical treatment (hypotensive eyedrops). A maximum of two transconjunctival needling revisions per patient was allowed in the needling arm. All patients underwent follow-up for 12 months. Successful treatment was defined as an intraocular pressure ≤ 18 mmHg and a 20% reduction from baseline at the final follow-up. Clinicaltrial.gov: NCT01887223. Mean intraocular pressure at the final 12-month follow-up was lower in the transconjunctival needling revision group compared to the medical treatment group. Similar numbers of eyes reached the criteria for treatment success in both the transconjunctival needling revision group and the medical treatment group. Despite similar success rates in eyes randomized to transconjunctival needling revision with 5-fluorouracil compared to eyes receiving medical treatment, there was a significantly lower mean intraocular pressure at 12 months after transconjunctival needling revision.
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Susanna-Jr, Remo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c560t-b2276d75ff8d5face20891525bbcc2b445588cfe8e6ae1dd53f62b5521f4e4963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>5-Fluorouracil</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antimetabolites - therapeutic use</topic><topic>Blister - etiology</topic><topic>Blister - therapy</topic><topic>Conjunctiva - drug effects</topic><topic>Conjunctiva - surgery</topic><topic>Encapsulated bleb</topic><topic>Female</topic><topic>Fluorouracil - therapeutic use</topic><topic>Glaucoma</topic><topic>Glaucoma - surgery</topic><topic>Humans</topic><topic>Intraocular Pressure</topic><topic>Male</topic><topic>Medical Treatment</topic><topic>MEDICINE, GENERAL &amp; INTERNAL</topic><topic>Middle Aged</topic><topic>Needles</topic><topic>Needling</topic><topic>Postoperative Complications</topic><topic>Prospective Studies</topic><topic>Rapid Communication</topic><topic>Revision</topic><topic>Statistics, Nonparametric</topic><topic>Time Factors</topic><topic>Trabeculectomy - adverse effects</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Suzuki, Ricardo</creatorcontrib><creatorcontrib>Susanna-Jr, Remo</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SciELO</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Clinics (São Paulo, Brazil)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Suzuki, Ricardo</au><au>Susanna-Jr, Remo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early transconjunctival needling revision with 5-fluorouracil versus medical treatment in encapsulated blebs: a 12-month prospective study</atitle><jtitle>Clinics (São Paulo, Brazil)</jtitle><addtitle>Clinics (Sao Paulo)</addtitle><date>2013-10-01</date><risdate>2013</risdate><volume>68</volume><issue>10</issue><spage>1376</spage><epage>1379</epage><pages>1376-1379</pages><issn>1807-5932</issn><issn>1980-5322</issn><eissn>1980-5322</eissn><abstract>To compare the efficacy of transconjunctival needling revision with 5-fluorouracil versus medical treatment in glaucomatous eyes with uncontrolled intraocular pressure due to encapsulated bleb after trabeculectomy. Prospective, randomized, interventional study. A total of 40 eyes in 39 patients with elevated intraocular pressure and encapsulated blebs diagnosed at a maximum five months after primary trabeculectomy with mitomycin C were included. The eyes were randomized to either transconjunctival needling revision with 5- fluorouracil or medical treatment (hypotensive eyedrops). A maximum of two transconjunctival needling revisions per patient was allowed in the needling arm. All patients underwent follow-up for 12 months. Successful treatment was defined as an intraocular pressure ≤ 18 mmHg and a 20% reduction from baseline at the final follow-up. Clinicaltrial.gov: NCT01887223. Mean intraocular pressure at the final 12-month follow-up was lower in the transconjunctival needling revision group compared to the medical treatment group. Similar numbers of eyes reached the criteria for treatment success in both the transconjunctival needling revision group and the medical treatment group. 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ispartof Clinics (São Paulo, Brazil), 2013-10, Vol.68 (10), p.1376-1379
issn 1807-5932
1980-5322
1980-5322
language eng
recordid cdi_doaj_primary_oai_doaj_org_article_558b2ee76ffd4ddf9a0e3d4c72e9f153
source ScienceDirect; PubMed Central Free; SciELO
subjects 5-Fluorouracil
Adult
Aged
Aged, 80 and over
Antimetabolites - therapeutic use
Blister - etiology
Blister - therapy
Conjunctiva - drug effects
Conjunctiva - surgery
Encapsulated bleb
Female
Fluorouracil - therapeutic use
Glaucoma
Glaucoma - surgery
Humans
Intraocular Pressure
Male
Medical Treatment
MEDICINE, GENERAL & INTERNAL
Middle Aged
Needles
Needling
Postoperative Complications
Prospective Studies
Rapid Communication
Revision
Statistics, Nonparametric
Time Factors
Trabeculectomy - adverse effects
Treatment Outcome
title Early transconjunctival needling revision with 5-fluorouracil versus medical treatment in encapsulated blebs: a 12-month prospective study
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