Needle revision with and without fluorouracil (5-fluorouracil) has been shown to be an effective procedure for the treatment of failed filtering blebs.1 Although several complications have been reported with the use of fluorouracil as an adjuvant to glaucoma filtering procedures, they are primarily related to the corneal epithelium.2 Little is known about the effects of this antimetabolite on the corneal endothelium. We recently treated two patients who underwent needle bleb revision with fluorouracil and in whom severe but reversible corneal edema subsequently developed.
Report of Cases.
In February 1992, a 52-year-old phakic black man with chronic end-stage open angle glaucoma underwent a trabeculectomy without antimetabolite. Because of early bleb fibrosis, a bleb needling procedure was performed. An insulin syringe (a small-gauge needle) was introduced subconjunctivally into the bleb area and then swept under the scleral flap to lyse adhesions. The needle was then withdrawn slightly and
Mazey BJ, Siegel MJ, Siegel LI, Dunn SP. Corneal Endothelial Toxic Effect Secondary to Fluorouracil Needle Bleb Revision. Arch Ophthalmol. 1994;112(11):1411. doi:10.1001/archopht.1994.01090230025011