Artikel
Needling revision: a Tanzanian study
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Autoren
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M. Schulze Schwering
- CCBRT - Disability Hospital, Dar Es Salaam, Tanzania; Universitäts- Augenklinik Tübingen
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R. Bowman
- CCBRT - Disability Hospital, Dar Es Salaam, Tanzania; ICEH International Center for Eye Health; London, UK
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J. Kabiru
- CCBRT - Disability Hospital, Dar Es Salaam, Tanzania
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M. L. Wood
- CCBRT - Disability Hospital, Dar Es Salaam, Tanzania
| Veröffentlicht: | 22. September 2004 |
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Gliederung
Text
Objective
To review the outcome of needle revision of trabeculectomy blebs in an East African population
Methods
A retrospective review of POAG patients records identified from the theatre operating book as having undergone needle revision of bleb during the period september 2002 to february 2004. Intraocular pressures prior to the needle revision, on the first day post-operatively and at latest follow-up were recorded, as were details of the procedure itself and the occurence of complications.
Results
31 patients were identified (mean age 60 years), 23 (74%) male. 5 fluorouracil was used in 18 cases ( 58 %).The procedure was performed with a 27 gauge needle or MVR - blade. Mean time between needling after trabeculectomy was 32 months. Mean post-needling follow-up time was 11 weeks and 70 % patients were followed up for at least four weeks. 11 / 35 patients (35 %) had acute post needling complications: 7 shallow AC; 3 subconjunctival haemorrhage; 1 hyphema. 10 / 18 needlings with 5 FU had complications (56 %) compared to 1 / 13 (8%) needlings without an antimetabolite (chisquare=7.6, p= 0.006). 6 / 31 (19%) patients needed re - needling. Mean needling-reneedling interval was 12 weeks. Mean pre - needling IOP was 27 (min 13 / max 40) Mean day 1 post - needling IOP was 8 (min 1 / max 34), significantly lower than pre-needling [ t = 9,1; p < 0,0005]. Mean IOP at latest follow up was 16 (min 7 / max 32), significantly lower than pre-needling [ t = 5,8; p < 0,0005]. 80 % day 1 IOPs were lower than 10 mm Hg and 70 % latest IOPs were lower than 20 mm Hg. 7 / 31 patients were put on antihypertensive medication (β-blocker) at latest follow-up.
Conclusions
Needle revision of trabeculectomy bleb produced a significant reduction in IOP with a mean follow-up of 11 weeks. The increased complication rate with 5FU deserves further investigation.
