A Cochrane review [Abstract] 1 included 1 study with 25 eyes. The study conducted in Brazil compared needling using a 27-gauge needle to medical treatment with aqueous suppressants and digital massage for the treatment of encapsulated trabeculectomy blebs. At one day post-treatment, mean intraocular pressure (IOP) was lower in the needling group (16.28 mm Hg, SD 5.9) than the medical group (19.45 mm Hg, SD 3.75); the difference was not statistically significant. At all other follow-up points, mean IOP was consistently higher in the needling group than the medical group, although the differences were not statistically significant. However, only 1/14 needled bleb remained successful (defined as IOP less than 20 mm Hg) at the end of follow-up compared to 10/11 blebs in the medical group. This difference was statistically highly significant (P=0.00003).
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment), and by imprecise results (limited study size for each comparison).
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