Risk factors for failure of 5-fluorouracil needling revision for failed conjunctival filtration blebs

Dong H. Shin, Yong Yeon Kim, Savita Y. Ginde, Paul H. Kim, Babak Eliassi-Rad, Anup K. Khatana, Nandita S. Keole

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

PURPOSE: To investigate the risk factors for failure of 5-fluorouracil (5-FU) needling revision, a useful procedure for restoring a failed filtration bleb. DESIGN: Interventional case series. METHODS: Retrospectively conducted study. SETTING: Institutional. STUDY POPULATION: Sixty-four eyes of 64 consecutive glaucoma patients that underwent 5-FU needling revisions for failed filtering bleb following either trabeculectomy or phaco-trabeculectomy with or without adjunctive mitomycin C (MMC). OBSERVATION PROCEDURES: Goldmann applanation tonometry, Kaplan-Meier survival analysis, and Cox proportional hazards regression analysis. MAIN OUTCOME MEASURES: Successful outcome of the initial 5-FU needling revision, arbitrarily defined as target intraocular pressure (IOP) control with not more than two topical glaucoma medications and no additional 5-FU needling or other surgical procedures, was analyzed by Kaplan-Meier survival analysis, and risk factors for failure of the initial 5-FU needling revision were analyzed by Cox proportional hazards regression analysis. RESULTS: The cumulative success rate of the initial 5-FU needling revision was 45% at 1 year, 33% at 2 years, and 28% at 4 years. Failure of the initial 5-FU revision correlated significantly with preneedling IOP > 30 mm Hg (P = .0003), lack of MMC use during the previous filtration surgery (P = .013), and IOP > 10 mm Hg immediately following needling revision (P = .0012) according to Cox's proportional hazards regression analysis. CONCLUSIONS: Pre-needling IOP > 30 mm Hg, lack of MMC use during the previous filtration surgery, and IOP > 10 mm Hg immediately after needling were found to be significant risk factors for failure of the initial 5-FU needling procedure. Therefore, it is important to monitor IOP closely following needling revision in those patients with such risk factors. They are more likely to require additional therapeutic interventions, including repeat needling revisions.

Original languageEnglish
Pages (from-to)875-880
Number of pages6
JournalAmerican Journal of Ophthalmology
Volume132
Issue number6
DOIs
Publication statusPublished - 2001 Dec 18
Externally publishedYes

Fingerprint

Blister
Fluorouracil
Intraocular Pressure
Mitomycin
Filtering Surgery
Trabeculectomy
Regression Analysis
Kaplan-Meier Estimate
Survival Analysis
Glaucoma
Manometry
Observation

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Risk factors for failure of 5-fluorouracil needling revision for failed conjunctival filtration blebs. / Shin, Dong H.; Kim, Yong Yeon; Ginde, Savita Y.; Kim, Paul H.; Eliassi-Rad, Babak; Khatana, Anup K.; Keole, Nandita S.

In: American Journal of Ophthalmology, Vol. 132, No. 6, 18.12.2001, p. 875-880.

Research output: Contribution to journalArticle

Shin, Dong H. ; Kim, Yong Yeon ; Ginde, Savita Y. ; Kim, Paul H. ; Eliassi-Rad, Babak ; Khatana, Anup K. ; Keole, Nandita S. / Risk factors for failure of 5-fluorouracil needling revision for failed conjunctival filtration blebs. In: American Journal of Ophthalmology. 2001 ; Vol. 132, No. 6. pp. 875-880.
@article{d626ed8d98bd44f5951f157711614af7,
title = "Risk factors for failure of 5-fluorouracil needling revision for failed conjunctival filtration blebs",
abstract = "PURPOSE: To investigate the risk factors for failure of 5-fluorouracil (5-FU) needling revision, a useful procedure for restoring a failed filtration bleb. DESIGN: Interventional case series. METHODS: Retrospectively conducted study. SETTING: Institutional. STUDY POPULATION: Sixty-four eyes of 64 consecutive glaucoma patients that underwent 5-FU needling revisions for failed filtering bleb following either trabeculectomy or phaco-trabeculectomy with or without adjunctive mitomycin C (MMC). OBSERVATION PROCEDURES: Goldmann applanation tonometry, Kaplan-Meier survival analysis, and Cox proportional hazards regression analysis. MAIN OUTCOME MEASURES: Successful outcome of the initial 5-FU needling revision, arbitrarily defined as target intraocular pressure (IOP) control with not more than two topical glaucoma medications and no additional 5-FU needling or other surgical procedures, was analyzed by Kaplan-Meier survival analysis, and risk factors for failure of the initial 5-FU needling revision were analyzed by Cox proportional hazards regression analysis. RESULTS: The cumulative success rate of the initial 5-FU needling revision was 45{\%} at 1 year, 33{\%} at 2 years, and 28{\%} at 4 years. Failure of the initial 5-FU revision correlated significantly with preneedling IOP > 30 mm Hg (P = .0003), lack of MMC use during the previous filtration surgery (P = .013), and IOP > 10 mm Hg immediately following needling revision (P = .0012) according to Cox's proportional hazards regression analysis. CONCLUSIONS: Pre-needling IOP > 30 mm Hg, lack of MMC use during the previous filtration surgery, and IOP > 10 mm Hg immediately after needling were found to be significant risk factors for failure of the initial 5-FU needling procedure. Therefore, it is important to monitor IOP closely following needling revision in those patients with such risk factors. They are more likely to require additional therapeutic interventions, including repeat needling revisions.",
author = "Shin, {Dong H.} and Kim, {Yong Yeon} and Ginde, {Savita Y.} and Kim, {Paul H.} and Babak Eliassi-Rad and Khatana, {Anup K.} and Keole, {Nandita S.}",
year = "2001",
month = "12",
day = "18",
doi = "10.1016/S0002-9394(01)01232-6",
language = "English",
volume = "132",
pages = "875--880",
journal = "American Journal of Ophthalmology",
issn = "0002-9394",
publisher = "Elsevier USA",
number = "6",

}

TY - JOUR

T1 - Risk factors for failure of 5-fluorouracil needling revision for failed conjunctival filtration blebs

AU - Shin, Dong H.

AU - Kim, Yong Yeon

AU - Ginde, Savita Y.

AU - Kim, Paul H.

AU - Eliassi-Rad, Babak

AU - Khatana, Anup K.

AU - Keole, Nandita S.

PY - 2001/12/18

Y1 - 2001/12/18

N2 - PURPOSE: To investigate the risk factors for failure of 5-fluorouracil (5-FU) needling revision, a useful procedure for restoring a failed filtration bleb. DESIGN: Interventional case series. METHODS: Retrospectively conducted study. SETTING: Institutional. STUDY POPULATION: Sixty-four eyes of 64 consecutive glaucoma patients that underwent 5-FU needling revisions for failed filtering bleb following either trabeculectomy or phaco-trabeculectomy with or without adjunctive mitomycin C (MMC). OBSERVATION PROCEDURES: Goldmann applanation tonometry, Kaplan-Meier survival analysis, and Cox proportional hazards regression analysis. MAIN OUTCOME MEASURES: Successful outcome of the initial 5-FU needling revision, arbitrarily defined as target intraocular pressure (IOP) control with not more than two topical glaucoma medications and no additional 5-FU needling or other surgical procedures, was analyzed by Kaplan-Meier survival analysis, and risk factors for failure of the initial 5-FU needling revision were analyzed by Cox proportional hazards regression analysis. RESULTS: The cumulative success rate of the initial 5-FU needling revision was 45% at 1 year, 33% at 2 years, and 28% at 4 years. Failure of the initial 5-FU revision correlated significantly with preneedling IOP > 30 mm Hg (P = .0003), lack of MMC use during the previous filtration surgery (P = .013), and IOP > 10 mm Hg immediately following needling revision (P = .0012) according to Cox's proportional hazards regression analysis. CONCLUSIONS: Pre-needling IOP > 30 mm Hg, lack of MMC use during the previous filtration surgery, and IOP > 10 mm Hg immediately after needling were found to be significant risk factors for failure of the initial 5-FU needling procedure. Therefore, it is important to monitor IOP closely following needling revision in those patients with such risk factors. They are more likely to require additional therapeutic interventions, including repeat needling revisions.

AB - PURPOSE: To investigate the risk factors for failure of 5-fluorouracil (5-FU) needling revision, a useful procedure for restoring a failed filtration bleb. DESIGN: Interventional case series. METHODS: Retrospectively conducted study. SETTING: Institutional. STUDY POPULATION: Sixty-four eyes of 64 consecutive glaucoma patients that underwent 5-FU needling revisions for failed filtering bleb following either trabeculectomy or phaco-trabeculectomy with or without adjunctive mitomycin C (MMC). OBSERVATION PROCEDURES: Goldmann applanation tonometry, Kaplan-Meier survival analysis, and Cox proportional hazards regression analysis. MAIN OUTCOME MEASURES: Successful outcome of the initial 5-FU needling revision, arbitrarily defined as target intraocular pressure (IOP) control with not more than two topical glaucoma medications and no additional 5-FU needling or other surgical procedures, was analyzed by Kaplan-Meier survival analysis, and risk factors for failure of the initial 5-FU needling revision were analyzed by Cox proportional hazards regression analysis. RESULTS: The cumulative success rate of the initial 5-FU needling revision was 45% at 1 year, 33% at 2 years, and 28% at 4 years. Failure of the initial 5-FU revision correlated significantly with preneedling IOP > 30 mm Hg (P = .0003), lack of MMC use during the previous filtration surgery (P = .013), and IOP > 10 mm Hg immediately following needling revision (P = .0012) according to Cox's proportional hazards regression analysis. CONCLUSIONS: Pre-needling IOP > 30 mm Hg, lack of MMC use during the previous filtration surgery, and IOP > 10 mm Hg immediately after needling were found to be significant risk factors for failure of the initial 5-FU needling procedure. Therefore, it is important to monitor IOP closely following needling revision in those patients with such risk factors. They are more likely to require additional therapeutic interventions, including repeat needling revisions.

UR - http://www.scopus.com/inward/record.url?scp=0035209569&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035209569&partnerID=8YFLogxK

U2 - 10.1016/S0002-9394(01)01232-6

DO - 10.1016/S0002-9394(01)01232-6

M3 - Article

C2 - 11730652

AN - SCOPUS:0035209569

VL - 132

SP - 875

EP - 880

JO - American Journal of Ophthalmology

JF - American Journal of Ophthalmology

SN - 0002-9394

IS - 6

ER -