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Needling for encapsulated trabeculectomy filtering blebs
1Eye Department, Royal Gwent NHS Trust, Cardiff Road, Newport, Wales, UK, NP20 2UB.
The Cochrane Database of Systematic Reviews
|April 24, 2004
Summary
Needling encapsulated blebs after trabeculectomy surgery does not improve intraocular pressure compared to medical treatment. This glaucoma surgery intervention showed lower success rates in a single trial.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Surgical Interventions
Background:
- Encapsulated filtering blebs following trabeculectomy can elevate intraocular pressure.
- This elevation may necessitate further medical or surgical intervention.
- Bleb needling is a potential method to re-establish drainage and lower intraocular pressure.
Purpose of the Study:
- To assess the efficacy of needling encapsulated blebs in reducing intraocular pressure.
- To compare the outcomes of bleb needling with medical management for encapsulated blebs.
Main Methods:
- Systematic review of randomized and quasi-randomized controlled trials.
- Searched multiple databases including Cochrane Central Register, MEDLINE, EMBASE, and LILACS.
- Included studies comparing bleb needling to antiglaucoma medication for encapsulated trabeculectomy blebs.
Main Results:
- One trial with 25 eyes met the inclusion criteria.
- Intraocular pressure was not significantly different between needling and medical groups at any follow-up point.
- Bleb success rates were significantly lower in the needling group (1/11) compared to the medical group (10/11).
Conclusions:
- Current evidence suggests bleb needling is not superior to medical treatment for encapsulated trabeculectomy blebs.
- Needling may lead to lower long-term success rates for filtering blebs.