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MMC appears more effective than 5-FU in needle revision of failed trabeculectomy blebs

J Glaucoma. 2009;18(7):513-520.

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Long-term follow-up showed that cases undergoing needle revision with mitomycin C maintained lower IOP and fewer glaucoma medications than needle revision cases with 5-fluorouracil for treatment of failed trabeculectomy blebs.

Researchers said that eyes that had needle revision with MMC were more likely to maintain IOP between 5 mm Hg and 16 mm Hg without glaucoma medication or additional surgery, at a rate of 61% at 2 years compared with 30% of 5-FU cases.

The study, a retrospective search of a database, reviewed results of 98 eyes of 95 patients who had needle revision with subconjunctival antimetabolite injections on the slit lamp over a 5-year period. Of those eyes, 45 received MMC and 53 received 5-FU. The 5-FU group had a significantly longer mean follow-up, 53 months, than the MMC group, 33.3 months.

Results showed that MMC could be more effective for needle revision than 5-FU, the authors said.

"MMC use and intraocular pressure drop immediately after needling as a continuous variable were significantly associated with success," they said.