Same-site surgical revision of failed trabeculectomy blebs with mitomycin C augmentation: long-term follow-up.

Abstract

PurposeTo determine the long-term outcomes of same-site revision of failed filtering blebs with mitomycin C application.Patients and methodsNoncomparative retrospective case series of 45 eyes of 39 patients. Main outcome measures were surgical success (≤21, ≤18, and ≤16 mm Hg reduction in intraocular pressure (IOP)). Other outcome measures included best-corrected visual acuity (VA), visual field loss, number of glaucoma medications, need for further interventions, time from surgery to recommencement of medications or interventions, and complications.ResultsMean follow-up was 126±59.6 months (range 16-227 months). The overall success proportion at last follow-up was 96% for IOP ≤21 mm Hg (criterion 1), 91% for IOP ≤18 mm Hg (criterion 2), and 84% for IOP ≤16 mm Hg (criterion 3). Absolute success at last follow-up was 64%, 38%, and 33% for criteria 1, 2, and 3, respectively. Mean baseline IOP was reduced from 24.2±5.5 to 12.4±5.5 mm Hg at last follow-up. Ten eyes (22%) had early and 3 (7%) eyes had late complications. None of these complications resulted in visual loss or surgery failure. Nine eyes (20%) required further glaucoma surgery. Nine eyes (20%) required further glaucoma laser.ConclusionsSame-site, augmented, bleb revision is a safe and effective technique to control IOP and prevent further visual loss in patients with failed trabeculectomies.