Treatment Overview
Needle Revision with Mitomycin-C (MMC) in Korea is a specialized Minimally Invasive Glaucoma Surgery (MIGS) technique used to restore function to a failing or scarred bleb after prior glaucoma surgeries such as trabeculectomy, micro-sclerostomy, subconjunctival MIGS, or filtering implant procedures. Over time, fibrosis or tissue adhesions can block fluid outflow, causing intraocular pressure (IOP) to rise. Needle revision re-opens the drainage pathway by using a fine needle to gently lift, separate, or release scar tissue—followed by precise application of Mitomycin-C, an anti-fibrotic agent that prevents re-scarring.
In Korea, this procedure is enhanced using OCT-guided bleb imaging, AI-based scar tissue mapping, micro-precision needle systems, digital bleb morphology assessment, and controlled MMC micro-dosing. These innovations allow surgeons to restore bleb function with exceptional accuracy, minimal discomfort, and long-lasting IOP control.
Purpose & Benefits
Purpose
- Reopen or rejuvenate a failing bleb after previous glaucoma surgery.
- Improve aqueous humor outflow by breaking scar tissue adhesions.
- Apply Mitomycin-C to reduce fibrosis and maintain long-term drainage.
- Lower IOP to safer levels when other treatments become less effective.
Benefits
- Highly Minimally Invasive: No large incisions; performed with micro-needles.
- Restores Previous Surgery: Avoids the need for repeat major glaucoma surgery.
- Controlled Anti-Fibrotic Action: MMC prevents rapid scar formation and improves durability.
- Quick Procedure: Typically completed in minutes.
- Fast Recovery: Minimal inflammation and rapid return to normal activity.
- Medication Reduction: Many patients reduce or eliminate the need for additional drops.
- Customizable: Targeted precisely to the area of scarring.
Ideal Candidates
Needle Revision with MMC in Korea is ideal for:
- Patients with a failing or encapsulated bleb after trabeculectomy or filtering MIGS.
- Individuals showing rising IOP due to bleb scarring or reduced filtration.
- Patients with early bleb failure who wish to avoid repeat incisional surgery.
- Individuals with Thick Tenon’s capsule, fibrosis, or early encapsulation.
- Patients who recently underwent filtering surgery but are already losing IOP control.
Possible Risks & Complications
Needle revision is much safer than repeat surgery, but mild temporary effects may include:
- Subconjunctival hemorrhage
- Mild discomfort or irritation
- Transient IOP fluctuations
- Minor leak at revision site (usually self-sealing)
- Over-filtration (rare and closely monitored)
- MMC-related tissue thinning (rare with Korean micro-dosing methods)
Korean surgeons minimize risks with:
- AI-guided MMC concentration calculations
- OCT imaging for bleb structure and scarring patterns
- Ultra-fine needles for delicate tissue separation
- Low-dose, targeted MMC application
Surgical Techniques
1. AI-Assisted Bleb & Scar Mapping
Identifies the exact areas of fibrosis or blockage.
2. Micro-Needle Entry
A fine 27–30G needle is used to access the bleb through a small conjunctival entry point.
3. Adhesion Release (Needling)
Scar tissue is gently broken or lifted to restore fluid flow.
4. Mitomycin-C Application
A precisely measured MMC dose is injected or applied to prevent re-scarring.
5. Digital Bleb Expansion
Viscoelastic may be used to re-shape the bleb dome for optimal filtration.
6. Real-Time OCT Feedback
Confirms bleb elevation, flow restoration, and tissue separation.
Treatment Process in Korea
Step-by-Step Workflow
Step 1 – Comprehensive Evaluation
Includes IOP measurement, bleb morphology assessment, anterior segment OCT, and fibrosis mapping.
Step 2 – Revision Planning
AI determines optimal needle entry points and MMC dosing.
Step 3 – Needle Revision Procedure
A micro-needle is used to open the bleb, release adhesions, and restore outflow.
Step 4 – Mitomycin-C Application
MMC is carefully applied to prevent rapid fibrosis.
Step 5 – Postoperative Monitoring
Follow-ups ensure stabilization of IOP and bleb morphology.
Treatment Duration: 5–10 minutes
Setting: Outpatient, same-day discharge
Recovery & After-Care
After-Care Guidelines
- Use antibiotic and anti-inflammatory drops for 1–2 weeks.
- Avoid rubbing the eye or applying pressure.
- Sleep with a protective eye shield for several nights.
- Monitor for changes in vision or increased tearing.
- Attend all follow-up visits for IO P and bleb evaluation.
Recovery Timeline
Days 1–3: Mild irritation, slight subconjunctival bleeding, early IOP improvement.
Week 1: Bleb remodeling stabilizes; outflow usually restored.
Weeks 2–4: IOP reduction becomes reliable; medication taper may begin.
1–3 Months: Long-term stability with restored filtering function.
Results & Longevity
Expected Results
- Significant improvement in bleb height and filtration.
- Effective and sustained IOP reduction.
- Avoidance of repeat major glaucoma surgery.
- Reduced need for topical medications.
Longevity
- Results commonly last years, especially with early intervention.
- MMC greatly increases long-term success by limiting fibrosis.
- Korean imaging protocols ensure ongoing monitoring and durability.
Why Korea Is a Top Destination
- Leaders in Bleb Revision Techniques: Korean surgeons specialize in minimally invasive filtration repair.
- Advanced Imaging: OCT and UBM used for real-time bleb anatomy modeling.
- AI-Enhanced MMC Dosing: Personalized anti-fibrotic treatment for maximum safety.
- Micro-Precision Instruments: Ultra-fine tools reduce trauma and improve success.
- Superior Clinical Outcomes: High long-term success rates with fewer complications than traditional revision techniques.
Unique Korean Innovations
- AI-based fibrosis segmentation and MMC micro-dosing.
- Digital bleb morphology and drainage-flow modeling.
- OCT-guided real-time needle placement.
- Hybrid revision protocols (Needling + canal-based MIGS, if required).
- Long-term IOP prediction using machine learning.
These advancements make Needle Revision with Mitomycin-C in Korea one of the most effective and minimally invasive solutions for restoring bleb function and maintaining long-term glaucoma control.
Cost Range (Indicative Estimate)
| Treatment Package | Price (KRW) | Approx. USD | Inclusions |
|---|---|---|---|
| Standard Needle Revision | ₩300,000 – ₩600,000 | ~$230 – $450 | Basic needling revision with standard MMC |
| Premium OCT-Guided MMC Revision | ₩800,000 – ₩1,500,000 | ~$600 – $1,150 | OCT mapping, AI-optimized MMC dosing, advanced imaging |
| Hybrid MIGS Revision Program | ₩2,000,000 – ₩4,000,000+ | ~$1,500 – $3,000+ | Needling + supplemental MIGS for enhanced long-term flow |
Pricing varies based on complexity, surgeon expertise, and need for imaging-guided MMC micro-dosing.
Popular Clinics in Korea
- B&VIIT Eye Center (Seoul): Leading center for bleb revision and filtration MIGS rescue procedures.
- Dream Eye Center (Seoul): Specialists in OCT-guided minimally invasive revision.
- BGN Eye Clinic (Seoul & Busan): Experts in MMC-enhanced scar revision and hybrid MIGS rescue.
- Glory Seoul Eye Clinic: Known for micro-precision needling and filtration repair.
- K-Cure Vision Center (Gangnam): Leaders in AI-driven revision planning and long-term monitoring.
