Needling revision of failed filtering blebs with adjunctive 5-fluorouracil

We investigated the outcome of needling revision with adjunctive subconjunctival 5-fluorouracil (5-FU) performed on 30 eyes of 30 consecutive glaucoma patients with failed filtering blebs 49.0 +/- 65.4 weeks after trabeculectomy. Follow up was 67.3 +/- 22.8 weeks from the time of the first needling revision and 49.9 +/- 26.2 weeks from the last needling procedure. Twenty-four (80%) of the eyes were treatment successes after 2.6 +/- 1.9 needling revisions, with a mean intraocular pressure (IOP) of 13.9 +/- 3.7 mm Hg on 1.5 +/- 1.1 medications, a significantly lower mean IOP and number of medications than before the procedure (32.5 +/- 7.8 mm Hg on 1.7 +/- 1.5 medications [P < .001, paired t-test]). Needling revision with adjunctive 5-FU appears to be a safe and effective means of reestablishing filtration.