Efficacy and Safety of Late Bleb Needling to Prolong Post-Trabeculectomy Hypotensive Effect
Purpose. To assess the efficacy and safety of late bleb needling to prolong the hypotensive effect after glaucoma surgery. Patients and Methods. The study included 130 patients (130 eyes) with IOP decompensation after trabeculectomy. The patients were divided into 3 groups: cystous blebs (50 eyes),...
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| Format: | Article |
| Language: | Russian |
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Ophthalmology Publishing Group
2019-01-01
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| Series: | Oftalʹmologiâ |
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| Online Access: | https://www.ophthalmojournal.com/opht/article/view/767 |
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| author | S. Yu. Petrov D. M. Safonova |
| author_facet | S. Yu. Petrov D. M. Safonova |
| author_sort | S. Yu. Petrov |
| collection | DOAJ |
| description | Purpose. To assess the efficacy and safety of late bleb needling to prolong the hypotensive effect after glaucoma surgery. Patients and Methods. The study included 130 patients (130 eyes) with IOP decompensation after trabeculectomy. The patients were divided into 3 groups: cystous blebs (50 eyes), incapsulated blebs (50 eyes) and biomicroscopically absent blebs that reveal intraocular fluid collections under the sclera flap during optical coherence tomography (30 eyes). All patients underwent tonometry, visometry and bleb hyperemia assessment. Results. Patients with cystous blebs showed a mean IOP reduction from 25.4 ± 3.2 mm Hg to 12.7 ± 4.5 mm Hg the day after needling. During the follow up period the mean IOP level showed a minimal fluctuation within the bounds of 13–15 mm Hg. Incapsulated blebs demonstrated a reduction from 28.9 ± 6.3 to 15.1 ± 4.3 mm Hg in the course of the first day. The following IOP fluctuations remained within a higher range, than in Group 1: 15.9–18.3 mm Hg. IOP dynamics in the visually absent bleb group had its specificts: the initial procedure led to a transient IOP increase from 24.6 ± 4.7 mm Hg to 27,6 ± 3,5 mm Hg, followed by a reduction within the first day to the level 19.4 ± 3.1 mm Hg, with further IOP fluctuations during the follow up period staying withing the range of 14.6–15.8 mm Hg. Performing bleb needling to restore trabeculectomy hypotensive efficacy had a total surgical success in 100 % patients with cystous blebs, that were formed as a result of conjunctival-scleral lesions. Incapsulated bleb needling had a 74 % total success rate and visually absent blebs with intraocular fluid collections under the flap had a 90 % total success rate within the 6 month follow up period. Conclusion. The study shows high efficacy of late needling of different blebs as an invasive measure of restoring post-trabeculectomy hypotensive effect. |
| format | Article |
| id | doaj-art-4d102f46d7474c62b8050d846667eb8f |
| institution | DOAJ |
| issn | 1816-5095 2500-0845 |
| language | Russian |
| publishDate | 2019-01-01 |
| publisher | Ophthalmology Publishing Group |
| record_format | Article |
| series | Oftalʹmologiâ |
| spelling | doaj-art-4d102f46d7474c62b8050d846667eb8f2025-08-20T03:22:18ZrusOphthalmology Publishing GroupOftalʹmologiâ1816-50952500-08452019-01-0115441642310.18008/1816-5095-2018-4-416-423472Efficacy and Safety of Late Bleb Needling to Prolong Post-Trabeculectomy Hypotensive EffectS. Yu. Petrov0D. M. Safonova1Research Institute of Eye DiseasesResearch Institute of Eye DiseasesPurpose. To assess the efficacy and safety of late bleb needling to prolong the hypotensive effect after glaucoma surgery. Patients and Methods. The study included 130 patients (130 eyes) with IOP decompensation after trabeculectomy. The patients were divided into 3 groups: cystous blebs (50 eyes), incapsulated blebs (50 eyes) and biomicroscopically absent blebs that reveal intraocular fluid collections under the sclera flap during optical coherence tomography (30 eyes). All patients underwent tonometry, visometry and bleb hyperemia assessment. Results. Patients with cystous blebs showed a mean IOP reduction from 25.4 ± 3.2 mm Hg to 12.7 ± 4.5 mm Hg the day after needling. During the follow up period the mean IOP level showed a minimal fluctuation within the bounds of 13–15 mm Hg. Incapsulated blebs demonstrated a reduction from 28.9 ± 6.3 to 15.1 ± 4.3 mm Hg in the course of the first day. The following IOP fluctuations remained within a higher range, than in Group 1: 15.9–18.3 mm Hg. IOP dynamics in the visually absent bleb group had its specificts: the initial procedure led to a transient IOP increase from 24.6 ± 4.7 mm Hg to 27,6 ± 3,5 mm Hg, followed by a reduction within the first day to the level 19.4 ± 3.1 mm Hg, with further IOP fluctuations during the follow up period staying withing the range of 14.6–15.8 mm Hg. Performing bleb needling to restore trabeculectomy hypotensive efficacy had a total surgical success in 100 % patients with cystous blebs, that were formed as a result of conjunctival-scleral lesions. Incapsulated bleb needling had a 74 % total success rate and visually absent blebs with intraocular fluid collections under the flap had a 90 % total success rate within the 6 month follow up period. Conclusion. The study shows high efficacy of late needling of different blebs as an invasive measure of restoring post-trabeculectomy hypotensive effect.https://www.ophthalmojournal.com/opht/article/view/767glaucomaneedlingtrabeculectomycystous blebsincapsulated |
| spellingShingle | S. Yu. Petrov D. M. Safonova Efficacy and Safety of Late Bleb Needling to Prolong Post-Trabeculectomy Hypotensive Effect Oftalʹmologiâ glaucoma needling trabeculectomy cystous blebs incapsulated |
| title | Efficacy and Safety of Late Bleb Needling to Prolong Post-Trabeculectomy Hypotensive Effect |
| title_full | Efficacy and Safety of Late Bleb Needling to Prolong Post-Trabeculectomy Hypotensive Effect |
| title_fullStr | Efficacy and Safety of Late Bleb Needling to Prolong Post-Trabeculectomy Hypotensive Effect |
| title_full_unstemmed | Efficacy and Safety of Late Bleb Needling to Prolong Post-Trabeculectomy Hypotensive Effect |
| title_short | Efficacy and Safety of Late Bleb Needling to Prolong Post-Trabeculectomy Hypotensive Effect |
| title_sort | efficacy and safety of late bleb needling to prolong post trabeculectomy hypotensive effect |
| topic | glaucoma needling trabeculectomy cystous blebs incapsulated |
| url | https://www.ophthalmojournal.com/opht/article/view/767 |
| work_keys_str_mv | AT syupetrov efficacyandsafetyoflateblebneedlingtoprolongposttrabeculectomyhypotensiveeffect AT dmsafonova efficacyandsafetyoflateblebneedlingtoprolongposttrabeculectomyhypotensiveeffect |