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(3) 15 Miscellaneous (27)

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Abstract #23698 Published in IGR 11-2

Effect of different application depths of mitomycin-C in deep sclerectomy with collagen implant: a randomized controlled trial

Mansouri K; Ravinet E
Clinical and Experimental Ophthalmology 2009; 37: 286-292

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PURPOSE: To evaluate effects of mitomycin-C (MMC) in deep sclerectomy with collagen implant applied under the superficial scleral flap or under the deep scleral flap. METHODS: Twenty-five patients with primary or secondary open-angle glaucoma and at high risk for postoperative cicatrization underwent deep sclerectomy and were randomly distributed to the two treatment arms. In the superficial MMC group (S-MMC), MMC was applied under the superficial scleral flap using a soaked sponge for 60 s; in the deep MMC group (D-MMC), MMC was applied under the deep scleral flap for 60 s before entering the Schlemm's canal. In both groups, remaining MMC was irrigated with 40 mL balanced salt solution. Patients were followed up for up to 2 years. The volume of filtering blebs was studied with ultrasound biomicroscopy at the last follow-up visit. RESULTS: Mean preoperative intraocular pressure (IOP) was 20.5 ± 8.9 mmHg for D-MMC and 21.6 ± 6.6 mmHg for S-MMC eyes (P = 0.67). The mean postoperative IOP was 5.3 ± 3.3 mmHg (D-MMC) and 6.9 ± 4.8 mmHg (S-MMC) at day 1 (P = 0.22) and 11.4 ± 6.3 mmHg (D-MMC) versus 11.3 ± 4.6 mmHg (S-MMC) at last follow up (P = 0. 54). The mean number of medications per patient was reduced from 2.5 ± 0.5 to 0.4 ± 0.5 (D-MMC) (P < 0.001) and from 2.5 ± 0.9 to 0.3 ± 0.4 (S-MMC) (P < 0.001). Ultrasound biomicroscopy at 24 months showed mean intrascleral space volume of 1.97 ± 0.35 mm3 (D-MMC) and 5.68 ±0.42 mm3 (S-MMC) (P < 0.05). CONCLUSION: No significant difference in efficacy and safety was found between the two groups at a mean of 19.2 months of follow up. Deep scleral application of MMC, however, seems to produce significantly smaller intrascleral blebs.

Glaucoma Unit, Jules Gonin Eye Hospital, Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland. kawehm@yahoo.com

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Classification:

12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
12.8.3 Non-perforating (Part of: 12 Surgical treatment > 12.8 Filtering surgery)

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