... Abstract Subconjunctival absorption of aqueous humor is an essential part of glaucoma filtration surgery. Mitomycin C (MMC) and 5-fluorouracil have been used to reduce postoperative episcleral fibrosis and scar formation in the filtering bleb area for more than 2 decades. Both antimetabolites...

... Abstract Subconjunctival absorption of aqueous humor is an essential part of glaucoma filtration surgery. Mitomycin C (MMC) and 5-fluorouracil have been used to reduce postoperative episcleral fibrosis and scar formation in the filtering bleb area for more than two decades. Both antimetabolites...

... found in the huge body of literature on glaucoma surgery. Key Factors Promoting and Opposing Filtration The mechanisms that affect the maintenance of optimal filtration are complex, and probably individual variations in the factors determining the final aspect of a filtering bleb, along...

... Failure The failure of glaucoma surgery in most cases originates from a fibroblastic conjunctival response at the bleb level in the early postoperative months. An excessive wound healing process characterized by inflammation and fibroblast proliferation and extracellular matrix deposition results...

... of trabeculectomy bleb. Eye 2003;17:441-442. 15. Epstein DL, Steinert RF, Puliafito CA: Neodymium-YAG laser therapy to the anterior hyaloid and aphakic malignant (ciliovitreal block) glaucoma. Am J Ophthalmol 1984;98:137-143. 16. Herschler J: Laser shrinkage of the ciliary processes: a treatment...

... subspecialties. Here, we describe the use of i 2 OCT in pediatric glaucoma surgery. It can be used to identify Schlemm’s canal, Barkan’s membrane, demonstrate the corneal pathology in Haab’s striae, and iris hypoplasia in cases of Axenfeld-Rieger anomaly. It can help identify drainage blebs that are filtering...

... inflammation and fibrosis, with subsequent IOP rise. Increased Rate of Glaucoma Surgery Failure The failure of glaucoma surgery in most cases originates from a fibroblastic conjunctival response at the bleb level in the early postoperative months. An excessive wound healing process characterized...

... in the huge body of literature on glaucoma surgery. Key Factors promoting and opposing Filtration The mechanisms that affect the maintenance of optimal filtration are complex, and probably individual variations in the factors determining the final aspect of a filtering bleb, along with the nature...

... and endothelial cell proliferation, but at the price of potentially vision-threatening side effects (especially when used at high concentrations), such as corneal toxicity, thin-walled avascular blebs, blebitis, endophthalmitis, and hypotony due to their nonspecific mechanism of action. The efficacy (and side...

... hypotony by minimising the risk of overdrainage, postoperative wound leaks, and poor bleb morphology. Surgical techniques to reduce the risk of postoperative fibrosis by the use of antifibrotic agents (including mitomycin C) are discussed in detail. These techniques are based on a combination...

... with cataract extraction. Intraocular pressure reduction to the mid-teens for viscocanalostomy and to the lower-teens for canaloplasty can be expected. The majority of complications seen in filtering surgery are largely eliminated by the nonpenetrating and bleb-independent approach. Postoperative care...

... hypotony by minimising the risk of overdrainage, postoperative wound leaks and poor bleb morphology. Surgical techniques to reduce the risk of postoperative fibrosis by the use of anti-fibrotic agents (including mitomycin C) are discussed in detail. These techniques are based on a combination...

... blebs. Arch Ophthalmol 2005;123:166-170. 7. Georgopoulos M, Vass C, Vatanparast Z, Wolfsberger A, Georgopoulos A: Activity of dissolved mitomycin C after different methods of long-term storage. J Glaucoma 2002;11:17-20. 8. Hu D, Chen PP, Oda D: The effect of mitomycin C after long-term storage...

.... Ramanathan US, Kumar V, O'Neill E, Shah P: Aqueous misdirection following needling of trabeculectomy bleb. Eye 2003;17:441-442 11. Epstein DL, Steinert RF, Puliafito C: Nd:YAG laser therapy to the anterior hyaloid and aphakic malignant (ciliovitreal block) glaucoma. Am J Ophthalmol 1984;98:137-143 12...

... reduction to the mid-teens for viscocanalostomy, and to the lower teens for canaloplasty can be expected. The majority of complications seen in filtering surgery are largely eliminated by the nonpenetrating and bleb-independent approach. Postoperative care is minimal as no bleb management like needling...

... in trabeculectomy surgery. J Glaucoma 2008;17:423-430 5. Loon SC, Chew PT: A major review of antimetabolites in glaucoma therapy. Ophthalmologica 1999;213:234-245 6. Francis BA, Du LT, Najafi K, Murthy R, Kurumety U, Rao N, Minckler DS: Histopathologic features of conjunctival filtering blebs. Arch...

.... Am J Ophthalmol 1993;116:673-683. 47. Hutchinson AK, Grossniklaus HE, Brown RH, McManus PE, Bradley CK: Clinicopathologic features of excised mitomycin filtering blebs. Arch Ophthalmol 1994;112:74-79. 48. Powers TP, Stewart WC, Stroman GA: Ultrastructural features of filtering blebs...

... observation concerning hypotony after trabeculectomy with adjunctive mitomycin-C. Am J Ophthalmol 1993;116:673-683 44. Hutchinson AK, Grossniklaus HE, Brown RH, McManus PE, Bradley CK: Clinicopathologic features of excised mitomycin filtering blebs. Arch Ophthalmol 1994;112:74-79 45. Powers TP...

... observed included hyphema, Descemet's membrane detachment, IOP spikes, and hypotony. The advantages of canaloplasty over trabeculectomy include (1) no subconjunctival bleb, (2) no need for antimetabolites, (3) fewer postoperative complications, and (4) a simplified follow-up. The disadvantages include (1...

... of intraoperative complications such as lens dislocation, capsular rupture, and vitreous loss [ 5 ]. Fig. 1 Dense cataract in an eye with functioning bleb and small pupil. Fig. 2 Postoperative examination at 1 week. Clear cornea incision should be considered, sparing the conjunctiva...