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Related Experiment Video

Updated: May 19, 2026

An Alternative and Validated Injection Method for Accessing the Subretinal Space via a Transcleral Posterior Approach

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Needling for encapsulated trabeculectomy filtering blebs.

Andrew Feyi-Waboso¹, Henry O D Ejere

¹Eye Department, Royal Gwent NHS Trust, Newport, UK. andrew.feyiwaboso@gwent.wales.nhs.uk.

The Cochrane Database of Systematic Reviews

|August 17, 2012

Summary

Needling encapsulated blebs after trabeculectomy did not significantly lower intraocular pressure compared to medical treatment. The procedure showed lower success rates in maintaining filtration compared to conservative management.

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Area of Science:

Ophthalmology
Glaucoma Surgery
Surgical Outcomes

Background:

Encapsulated filtering blebs after trabeculectomy can cause elevated intraocular pressure, necessitating further intervention.
Bleb needling is a proposed method to restore filtration and reduce intraocular pressure.

Purpose of the Study:

To evaluate the effectiveness of needling encapsulated blebs in lowering intraocular pressure.

Main Methods:

A systematic review of randomized and quasi-randomized trials comparing bleb needling with medical treatment for encapsulated trabeculectomy blebs.
Searched multiple databases including CENTRAL, MEDLINE, EMBASE, LILACS, mRCT, ClinicalTrials.gov, and WHO ICTRP up to February 2012.
Primary outcome was mean intraocular pressure at various follow-up points.

Main Results:

One trial with 25 eyes met the inclusion criteria.
Intraocular pressure was not significantly different between needling and medical treatment 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 reducing intraocular pressure in encapsulated blebs.
The procedure demonstrated a significantly lower success rate in maintaining bleb function.