AIM: To observe the treatment method and efficacy to the earlier dysfunctional filtering blebs of refractory glaucoma, and investigate safer and more effective treatment method.

METHODS: Twenty eyes of 20 patients with refractory glaucoma were included in this study between January 2006 and January 2012, every eye had the failing filtering bleb(or failing tendency)after suffering trabeculectomy. The treatment methods included eyeball massage or after breaking suture of sclera, and bled needling with a blunt needle or 5-fluorouracil(5-FU)subconjunctival injection. All patients underwent the treatment of failing filtering blebs 3-8 days after trabeculectomy with mitomycin-C. All the patients were followed up for 6 months.

RESULTS: After massage and revision with bled needling and 5-FU subconjunctival injection, the failing filtering blebs turned to be functional blebs in 18 eyes(90%). The average intraocular pressures(IOPs)were 24.61±5.4mmHg(1mmHg=0.133KPa)before treatment and 15.20±4.8mmHg 6 months after treatment. There was significant difference in IOP between pre- and post treatment eyes(P<0.001). No any severe complications were found during and after surgery.

CONCLUSION: Refractory glaucoma was more complicated, and the failing filtering bleb(or failing tendency)was more readily available after suffering trabeculectomy. Eyeball massage or after breaking suture of sclera, and bled needling with a blunt needle or 5-FU subconjunctival injection are a safer and more effective method to treat early dysfunctional filtering bleb after glaucoma trabeculectomy, and it can improve the success rate of surgery.