Editors Selection IGR 8-2

Surgical treatment: Acupuncture separation

Ningli Wang

Comment by Ningli Wang on:

13601 Treating earlier malfunction filtering bleb with acupuncture separation combined with injection of 5-FU around the filtering bleb after glaucoma filtration surgery, Zhang W-Q; Zhou H-Z; Zhou X, International Journal of Ophthalmology, 2006; 6: 196-198

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The acupuncture separation combined with injection of 5-FU around the filtering bleb has been used for treating earlier malfunction filtering bleb after glaucoma filtration surgery for ten years. The earliest reports about this method appeared around 1990s1,2 and it has been proved effective and widely used in clinic.

Zhang et al. (591) evaluated the validity and safety of this method again in a cohort study. The design of study was similar to prior studies. The authors discuss the results in 25 eyes which during a three months period had a malfunctioning bleb. Injections of 5-FU were given five times every other day. The outcome consisted of IOP, form of the bleb, and complications. Twenty-one of the 25 eyes had an IOP of below 21 mmHg and 18 below 15 mmHg. The injection dose of 5-FU was smaller than other studies and the result proved this dose of 5-FU had the similar effect.

The conclusion of this article was supported by the data and will support clinical practice. But there were two questions worth to be discussed with the author. First the injection place of 5-FU in this article was around the filtering bleb that may increase the probability of 5-FU coming into the anterior chamber. Second the changes of the filtering bleb and IOP pre- and post- surgery should be analyzed by statistics method.

NB It seems that our Chinese colleagues use the term 'acupuncture' instead of 'needling'.


  1. Gillies WE, Brooks AM. Restoring the function of the failed bleb. Aust N Z J Ophthalmol 1991; 19: 49-51.
  2. Hodge W, Saheb N, Balazsi G, Kasner O. Treatment of encapsulated blebs with 30-gauge needling and injection of low-dose 5-fluorouracil. Can J Ophthalmol 1992; 27: 233-236.

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