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  5. FP0521 : Internal revision: A viable method for bleb revival

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DR. ARSHI SINGH

Dr. KIRTI SINGH, Dr. Neha Sachdeva

Abstract

Aim: Report outcomes of novel, “internal revision” combined with bleb needling in failing blebs

Methods: Failed blebs, subsequent to gonioscopic confirmed blocked sclerostomy by iris/ fibrosis, scheduled for repeat trabeculectomy were taken up for ab interno “internal revision,” where blocked internal ostium was swept free of iris / fibrous tissue by a rod manipulator through a side port, followed by 5-FU/ MMC augmented ab externo needling.

Results: 26 eyes with mean age 51±15 years were included. Bleb maturity (date from trabeculectomy) was early (<3 months in 3), intermediate (4-12 months in 5) and late (>1 year in 18).

Mean IOP reduction at 3 months 32±18%, maximum reduction in early group at 40%. Mean IOP reduced from 24.5±3.4 to 16.2±4.3 mmHg in 5-FU group (12 patients) &amp; 27.4±9 to 18.2±6.6 mmHg in MMC group (14 patients). Self-limiting complications -hyphema (2) &amp; subconjunctival hemorrhage (15).

Conclusion: “Internal revision” is effective procedure for bleb revival

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