Research Article

Safety and Efficacy of Bleb Needling with Antimetabolite after Trabeculectomy Failure in Glaucoma Patients: A Systemic Review and Meta-Analysis

Table 1

Baseline characteristics of included studies.

Author, yearDesignNumber of eyesMean age (SD) (years)Mean follow-up (SD) (months)Diagnosis for study eyes (numbers (%))Phakic status for study eyes (numbers (%))MedicationCountry/region

Rabiolo et al., 2019 [10]Noncomparative, retrospective15765.8 (13.9)25 (30.37)POAG: 85 (54.1)
PACG: 11 (7.0)
Secondary glaucoma: 61 (38.9)
Pseudo: 140 (89.2); phakic: 16 (10.2); aphakic: 1 (0.6)5-FuItaly
Okka et al., 2019 [11]Noncomparative, retrospective1646 (18.2)12.22 (6.08)POAG: 9 (56.3)
Secondary glaucoma: 7 (44)
N/A5-FuTurkey
Kim et al., 2019 [12]Comparative, retrospective3558.5 (13.1)>6 (N/A)POAG: 21 (60.0)
PACG: 3 (8.6)
Secondary glaucoma: 11 (31.4)
N/A5-FuSouth Korea
Than et al., 2018 [13]Noncomparative, retrospective9667 (15)37.08 (21)POAG: 70 (72.9)
PACG: 6 (6.25)
Secondary glaucoma: 18 (18.75)
N/A: 2 (2.1)
Pseudo: 24 (25); phakic: 72 (75)5-FuUK
Pathak-Ray and Choudhari, 2018 [14]Noncomparative, prospective3959 (14.25)20 (11)POAG: 9 (23.1)
PACG: 21 (53.8)
Secondary glaucoma: 9 (23.1)
Pseudo: 26 (66.7); phakic: 13 (33.3)MMCIndia
Lin et al., 2018 [15]Noncomparative, retrospective4473.7 (N/A)58.7 (N/A)POAG: 29 (65.9)
PACG: 7 (15.9)
Secondary glaucoma: 8 (18.2)
Pseudo: 28 (63.6); phakic: 16 (36.4)MMCUK
Zheng et al., 2016 [16]Noncomparative, retrospective3368.67 (10.38)21.72 (18.72)POAG: 21 (67.7)
PACG: 2 (6.5)
Secondary glaucoma: 8 (25.8)#
N/A5-FuAustralia
Tulidowicz-Bielak et al., 2016 [17]Noncomparative, retrospective12167.38 (13.76)27.6 (N/A)POAG: 121 (100)Single needling: pseudo: 62 (51.2); phakic: 38 (31.4); multiple needling: unknown 21 (17.4)MMCPoland
Panarelli et al., 2016 [18]Noncomparative, retrospective2769.1 (13.1)54.2 (30.4)POAG: 18 (66.7)
PACG: 2 (7.4)
Secondary glaucoma: 7 (25.9)
Pseudo: 17 (63.0); phakic: 9 (33.3); aphakic: 1 (3.7)MMCUSA
Liu et al., 2016 [19]RCT7548.5 (10.4)12 (N/A)MMC : POAG: 14 (35.0) PACG: 23 (57.5)
Juvenile glaucoma: 3 (7.5) 5-Fu : POAG: 12 (34.3)
PACG: 20 (57.1)
Juvenile glaucoma: 1 (2.9)
Secondary glaucoma: 2 (5.7)
N/AMMC/5-FuChina
Lee et al., 2016 [20]Comparative, retrospective4152.1 (15.8)22.7 (9.4)POAG: 8 (19.5)
PACG: 5 (12.2)
Secondary glaucoma: 28 (68.3)
Pseudo: 19 (46.3); phakic: 21 (51.2); aphakic: 1 (2.4)5-FuChina
Tsai et al., 2015 [21]Comparative, retrospective22766.9 (11.2)>6 (N/A)POAG: 157 (69.2)
PACG: 70 (30.8)
N/A5-FuSingapore
Tatham et al., 2013 [22]Comparative, retrospective3467.88 (N/A)25.2 (1.2)POAG: 21 (61.8)
PACG: 5 (14.7)
Secondary glaucoma: 8 (23.5)
Pseudo: 17 (50.0); phakic: 17 (50.0)5-FuUK
Suzuki and Susanna-Jr, 2013 [23]RCT2057.3 (15.21)12 (N/A)POAG: 17 (85.0)
Congenital glaucoma: 1 (5.0)
Secondary glaucoma: 2 (10.0)
N/A5-FuBrazil
Dalvi et al., 2012 [24]Comparative, retrospective4067.83 (12.02)60 (N/A)POAG: 28 (70.0)
PACG: 6 (15.0)
Secondary glaucoma: 6 (15.0)
Pseudo: 20 (50.0); phakic: 20 (50.0)5-FuCanada
Amini et al., 2012 [7]Noncomparative, retrospective2756.5 (16.2)20.31 (15.63)POAG: 7 (26.0)
PACG: 4 (14.8)
Juvenile glaucoma: 4 (14.8)
Secondary glaucoma: 11 (40.7)
Developmental glaucoma: 1 (3.7)
N/AMMCIran
Maestrini et al., 2011 [25]Noncomparative, prospective12561.6 (18.8)20.8 (12)POAG: 97 (77.6)
PACG: 10 (8.0)
Congenital glaucoma: 6 (4.8)
Secondary glaucoma: 12 (9.6)
Pseudo: 53 (42.4); phakic: 69 (55.2); aphakic: 3 (2.4)MMCBrazil
Palejwala et al., 2010 [26]Comparative, retrospective10774.35 (11.95)10.55 (11.01)POAG: 81 (75.7)
PACG: 3 (2.8)
Secondary glaucoma: 23 (21.5)
Pseudo: 48 (44.9); phakic: 58 (54.2); aphakic: 1 (0.9)MMC/5-FuUSA
Elsayed and El-Raggal, 2010 [27]Noncomparative, retrospective307.3 (3.4)9.23 (5.25)Congenital glaucoma: 30 (100)N/AMMCEgypt
Kapasi and Birt, 2009 [28]Noncomparative, retrospective3771.2 (12.6)24 (N/A)N/AN/A5-FuCanada
Anand and Khan, 2009 [29]Comparative, retrospective9873.5 (11.1)53 (18.12)5-Fu: POAG: 45 (88.2)
PACG: 5 (9.8)
Secondary glaucoma: 1 (2.0)
MMC: POAG: 37 (841)
PACG: 4 (9.0)
Secondary glaucoma: 3 (6.9)#
MMC group: pseudo: 28 (62.2); phakic: 17 (37.8); 5-Fu group: pseudo: 30 (56.6); phakic: 23 (43.4)MMC/5-FuUK
Zarei et al., 2008 [30]Noncomparative, prospective3345.67 (22.41)9.24 (5.27)POAG: 9 (27.3)
PACG: 4 (12.1)
Congenital glaucoma: 6 (18.2)
Juvenile glaucoma: 4 (12.1)
Developmental glaucoma: 1 (2.7)
Secondary glaucoma: 9 (27.3)
N/AMMCIran
Rotchford and King, 2008 [2]Noncomparative, prospective8170 (N/A)40.27 (N/A)POAG: 56 (69.1) PACG: 8 (9.9) secondary glaucoma: 17 (21.0)Pseudo: 27 (33.3); phakic: 54 (66.7)5-FuUK
Gutierrez-Ortiz et al., 2006 [31]Noncomparative, prospective3465.9 (8.3)14.2 (9.8)POAG: 23 (67.6) PACG: 5 (14.7)
Juvenile glaucoma: 1 (2.9)
Secondary glaucoma: 5 (14.7)
N/AMMCSpain
Shetty et al., 2005 [32]Noncomparative, retrospective4472.9 (10.4)>12 (NA)POAG: 35 (79.5)
PACG: 4 (9.1)
Secondary glaucoma: 5 (11.4)
Pseudo: 31 (70.5); phakic: 12 (27.3); aphakic: 1 (2.3)MMCUSA
Jacobs et al., 2005 [33]Noncomparative, retrospective2861 (N/A)14 (N/A)N/AN/A5-FuBelgium
Paris et al., 2004 [34]Noncomparative, retrospective36N/A6 (N/A)POAG: 36 (100)N/A5-FuUSA
Broadway et al., 2004 [35]Noncomparative, retrospective10169 (11)20.2 (NA)POAG: 71 (70.2)
PACG: 5 (5.0)
Secondary glaucoma: 25 (24.8)
Pseudo: 16 (15.8); phakic: 12 (79.2); aphakic: 5 (5.0)5-FuUK
Ben-Simon and Glovinsky, 2003 [36]Noncomparative, retrospective4165 (17)6 (N/A)POAG: 26 (63.4)
PACG: 2 (4.9)
Congenital glaucoma: 2 (4.9)
Secondary glaucoma: 11 (26.8)
Pseudo: 22 (53.7); phakic: 13 (31.7); aphakic: 6 (14.6)MMCIsrael
Hawkins et al., 2002 [37]Noncomparative, retrospective4970.14 (13.74)19.9 (16.3)POAG: 25 (58.1)
PACG: 8 (18.6)
Secondary glaucoma: 10 (23.3)#
Pseudo/aphakic: 32 (74.4); phakic: 11 (25.6)5-FuUSA
Chang and Hou, 2002 [38]Noncomparative, retrospective2553.0 (13.2)8.32 (6.61)POAG: 4 (16.0)
PACG: 4 (16.0)
Secondary glaucoma: 17 (68.0)
Pseudo: 12 (48.0); phakic: 6 (24.0); aphakic: 7 (28.0)5-FuChina
Shin et al., 2001 [39]Noncomparative, retrospective6472.1 (9.5)44.2 (21.2)POAG: 61 (95.3)
PACG: 2 (3.1)
Secondary glaucoma: 1 (1.6)
Pseudo: 10 (15.6); phakic: 51 (79.7); aphakic: 3 (4.7)5-FuUSA
Kapetansky and Kapetansky, 1999 [8]Comparative, retrospective30N/A>6 (N/A)N/AN/AMMCUSA
Allen et al., 1998 [40]Noncomparative, retrospective3263.9 (10.8)10.7 (2.9)POAG: 20 (62.5)
PACG: 5 (15.6)
Secondary glaucoma: 7 (21.9)
Pseudo: 6 (18.8); phakic: 24 (75.0); aphakic: 2 (6.2)5-FuUK
Mardelli et al., 1996 [4]Noncomparative, retrospective6272 (15)9.9 (3.7)POAG: 32 (51.6)
PACG: 9 (14.5)
Congenital glaucoma: 4 (6.5)
Secondary glaucoma: 17 (27.4)
Pseudo: 42 (67.8); phakic: 17 (27.4); aphakic: 3 (4.8)MMCUSA
Greenfield et al., 1996 [41]Comparative, retrospective6372.3 (11.2)13.1 (8.1)POAG: 32 (50.8)
PACG: 9 (14.3)
Secondary glaucoma: 22 (34.9)
Pseudo: 27 (42.9); phakic: 36 (57.1)MMCUSA
Shin et al., 1993 [9]Comparative, retrospective3063.5 (14.5)15.5 (5.2)POAG: 22 (73.3)
Secondary glaucoma: 8 (26.7)
Pseudo: 17 (56.7); phakic: 10 (33.3); aphakic: 3 (10.0)5-FuUSA

MMC: mitomycin C; PACG: primary angle-closure glaucoma; POAG: primary open-angle glaucoma; RCT: randomized-control trial; SD: standard deviation; 5-Fu: 5-fluorouracil. N/A meant that the data were not presented in the original article. Secondary glaucoma included pseudoexfoliated glaucoma, uveitic glaucoma, pigmentary glaucoma, traumatic glaucoma, steroid-induced glaucoma, neovascular glaucoma, iridocorneal endothelial syndrome, and so on. Developmental glaucoma included Axenfeld-Reiger Syndrome, Sturge-Weber Syndrome, and so on. Number of patients was displayed.