Risk Factors for the Development of Encapsulated Filtering Blebs: The Role of Surgical Glove Powder and 5-fluorouracil

Abstract

To study risk factors for the development of encapsulated filtering bleb, especially the effect of surgical glove powder and 5-fluorouracil on the development of encapsulated blebs. One hundred forty-eight patients who underwent trabeculectomy were prospectively studied. After patient of each surgeon were divided into two subgroups of 5-fluorouracil versus no 5-fluorouracil, each subgroup was then randomized for powder versus powder-free surgical gloves. All patients were followed for at least 2 months (mean, 3.5 months; range, 2-10 months). The overall incidence of encapsulated bleb was 11.2% when an encapsulated bleb was defined by clinical characteristics with a peak intraocular pressure of 26 mmHg or higher. The group that received 5-fluorouracil had a lower incidence of encapsulated blebs despite a higher rate of previous surgeries, whereas the group with powdered gloves had increased incidence. The subgroup in which powder-free gloves were used in conjunction with postoperative injections of 5-fluorouracil had the lowest incidence of encapsulated blebs (2.6%) compared with the other subgroups (12.0%-17.9%) (P = 0.01). Combined use of powder-free surgical gloves and 5-fluorouracil may reduce the incidence of encapsulated bleb.