Outcomes of Bleb Revision With Mitomycin C After Ex-PRESS Shunt Surgery.

PURPOSE

Investigate efficacy and safety of bleb revision using mitomycin C after Ex-PRESS shunt surgery.

PATIENTS AND METHODS

We performed chart reviews of 36 consecutive eyes from 34 patients with previous Ex-PRESS shunt surgery who underwent subsequent bleb revision with mitomycin C. The mean follow-up time was 13.5 months. The primary outcome measure was surgical success. Secondary outcomes included visual acuity, intraocular pressure, number of medications, and complications.

RESULTS

Twenty-four eyes had open-angle glaucoma (61.1%). Mean time from Ex-PRESS to bleb revision was 8.8 months. Complete success rate for the immediate 3-month postoperative period was 94.4% and qualified success rate was 97.2%. Complete and qualified success rates for the entire follow-up period were 40% and 65.7%, respectively. Visual acuity remained stable throughout the study period, and at 1 year, average intraocular pressure was 14.7 mm Hg on an average of 1.7 medications. No major complications were reported.

CONCLUSIONS

Bleb revision in eyes with an Ex-PRESS shunt is a safe and efficacious procedure. The surgical outcomes are within the range of published outcomes for bleb needling after trabeculectomy. Further research with larger sample size and longer follow-up is needed to confirm these results.