Abstract

Study Design
Comparative interventional

Purpose
Efficacy of needling to revive failed trabeculectomy bleb using 2 doses of MMC
Correlate changes in bleb ASOCT with IOP

Method
50 patients with high IOP post trabeculectomy were assigned into 2 groups. Group A underwent needling with 60ug,Group B with 20ug. Complete success was IOP of >6 &<18mmHg or IOP reduction of >20% withoutAGMs. Qualified success was defined as above criteria fulfilled with supplemental AGMs. Bleb function was evaluated by IOP control over 6 months & structure by changes in microcystic spaces, bleb height, bleb wall on ASOCT. Safety profile of both doses was assessed

Results
Filters needled with 60ug had complete success of 40% w.r.t 16% in 20ug with mean IOP reduction of 13.09 mmHg±4.02 & 11.36±8.48 respectively
Post-op ASOCT showed increased microcysts. SCH was seen in 88%

Conclusion
Highdose MMC(60ug) is more effective for needling with no adverse outcomes
ASOCT bleb changes correlate well with post-op IOP