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oai:www.peertechzpublications.org:10.17352/2455-1414.000008 2014-12-12 PTZ.JCRO:VOL2

Needle Revision with Antimetabolites in Bleb Failure Ehab Ghoneim<p>Glaucoma filtering surgery is unusual in that its goal is the creation and maintenance of a non healing fistula between two anatomic spaces that are normally not connected [1]. <br></p><p>Fibroblasts, connective tissue elements, cytokines, aqueous humor and the surrounding vascular supply all influence what happens to a bleb over a long period of time.</p><p>The enemy of drainage procedure is excessive scarring [2]. <br></p><p>Long-term studies showed a loss of intraocular pressure (IOP) control in a significant proportion of eyes with an initially successful trabeculectomy [2,3]. So follow up of glaucoma patients after surgery is mandatory as significant proportion develop bleb failure.</p><p>Revision of guarded filtration procedures was reported as early as 1941 by Ferrer [4]. Needling as currently performed was described by Pederson and Smith [5]. The combination of needling with antimetabolites (mitomycin C and 5FU) greatly improve the outcome of needling and enhance bleb survival.</p> Journal of Clinical Research and Ophthalmology - Peertechz Publications 2014-12-12 Mini Review https://doi.org/10.17352/2455-1414.000008 en Copyright © Ehab Ghoneim et al.