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Anti-inflammatory fibrosis suppression in threatened trabeculectomy bleb failure produces good long term control of intraocular pressure without risk of sight threatening complications
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  1. J R Fuller1,
  2. T H Bevin1,
  3. A C B Molteno1,
  4. B J T Vote2,
  5. P Herbison3
  1. 1Department of Ophthalmology, University of Otago Medical School, Dunedin, New Zealand
  2. 2Department of Ophthalmology, Dunedin Hospital, Dunedin, New Zealand
  3. 3Department of Preventive and Social Medicine, University of Otago Medical School, Dunedin, New Zealand
  1. Correspondence to: Professor A C B Molteno, Department of Ophthalmology, University of Otago Medical School, PO Box 913, Dunedin, New Zealand; georgi.bond{at}healthotago.co.nz

Abstract

Aims: To determine the long term outcome of systemic anti-inflammatory fibrosis suppression in cases of threatened trabeculectomy bleb failure in open angle glaucoma.

Methods: This prospective non-comparative case series followed 77 eyes of 63 patients which showed signs of threatened early bleb failure and were treated with oral anti-inflammatory fibrosis suppression of prednisone, a non-steroidal anti-inflammatory agent, and colchicine taken for a mean period of 6 weeks, in addition to standard postoperative topical treatment, for a mean follow up of 6 years.

Results: Trabeculectomy with anti-inflammatory fibrosis suppression controlled the IOP at ≤21 mm Hg with a probability of 0.91 (95% CI: 0.81 to 1.0) at 8 years and 0.89 (95% CI: 0.56 to 1.1) at 12 years. There were no reported cases of endophthalmitis, hypotonous maculopathy, late bleb leak, or serious systemic side effects.

Conclusion: Anti-inflammatory fibrosis suppression provided good control of bleb fibrosis without risk of sight threatening complications in a patient group at high risk of bleb failure.

  • fibrosis
  • aqueous
  • trabeculectomy
  • anti-inflammatory fibrosis suppression
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