Perucho-Martínez S, Gutiérrez-Díaz E, Montero-Rodríguez M, Mencía-Gutiérrez E, Lago-Llinás M D
Servicio de Oftalmología, Hospital Universitario 12 de Octubre, C/Cabo San Vicente 10, 28924 Madrid, Spain.
Arch Soc Esp Oftalmol. 2006 Sep;81(9):517-22. doi: 10.4321/s0365-66912006000900006.
To evaluate the results of bleb needling in eyes subjected to filtering surgery six months or more previously.
A retrospective study of 23 eyes in 21 patients subjected to bleb needling performed by means of a 25G needle, 6 months to 23 years after failed filtering surgery (mean 67.3 months). The mean number of bleb needlings was 1.2 and the mean number of 5-fluorouracil subconjunctival injections was 3.9.
The mean intraocular pressure (IOP) before needling was 26 mmHg and the mean anti-glaucoma medications was 1.3 per eye. The mean postoperative IOP was 16.3 mmHg and mean anti-glaucoma medications 0.7. A diffuse filtering bleb was evident in 12 eyes (54.5%). The results of needling were worse in eyes subjected to previous surgery for glaucoma or other failed bleb needling procedures (75% failure).
Needle revision of the filtering bleb is a simple and safe technique that offers good results even years after a filtering surgery had been performed. It should be considered before other medical or surgical treatments in patients with a previously functioning bleb and a permeable sclerectomy site at gonioscopy.
评估对6个月或更久之前接受过滤过手术的眼睛进行滤泡针刺的效果。
对21例患者的23只眼睛进行回顾性研究，这些眼睛在滤过手术失败6个月至23年后（平均67.3个月）接受了25G针头的滤泡针刺。滤泡针刺的平均次数为1.2次，结膜下注射5-氟尿嘧啶的平均次数为3.9次。
针刺前平均眼压（IOP）为26 mmHg，每只眼睛平均使用抗青光眼药物1.3种。术后平均眼压为16.3 mmHg，平均抗青光眼药物为0.7种。12只眼睛（54.5%）出现弥漫性滤过泡。既往接受过青光眼手术或其他滤泡针刺失败手术的眼睛针刺效果较差（失败率75%）。
滤过泡针刺修复是一种简单安全的技术，即使在滤过手术后数年也能取得良好效果。对于既往滤过泡功能良好且房角镜检查显示巩膜切除部位可通透的患者，在进行其他药物或手术治疗之前应考虑该方法。
