Neodymium: YAG transconjunctival laser revision of late-failing filtering blebs.

Abstract

To study the effectiveness of neodymium:YAG (Nd:YAG) laser transconjunctival revision of late-failing filtering blebs. Retrospective, noncomparative case series. Thirty consecutive patients from a glaucoma referral practice at the Ohio State University Department of Ophthalmology. Transconjunctival Nd:YAG laser revision of blebs diagnosed as failing secondary to episcleral fibrosis. Reduction in intraocular pressure (IOP) and survival of bleb. Reduction in IOP was attained in 24 (80%) of 30 patients with a mean prelaser IOP of 21.21 mmHg and a mean 1-week postlaser IOP of 13.97 mmHg (P < 0.0001). These results were maintained at the 1-, 3-, and 12-month follow-up visits with mean IOPs of 16.31 mmHg (P = 0.0008), 14.81 mmHg (P < 0.0001), and 15.25 mmHg (P = 0.0003), respectively. Two-year data were available on a small number of patients (4) with a mean of 15.25 mmHg (P = 0.0085). Mean time interval between trabeculectomy and laser revision was 31 months. Late-failing filtering blebs are often amenable to Nd:YAG transconjunctival revision.