advertisement
Abstract #6930 Published in IGR 4-1
Long-term effects of simultaneous subconjunctival and subscleral mitomycin C application in repeat trabeculectomy
You YA; Gu YS; Fang CT; Ma XQJournal of Glaucoma 2002; 11: 110-118
PURPOSE: To assess the efficacy and safety of simultaneous mitomycin C application under conjunctival and scleral flaps in patients with repeat trabeculectomy. METHODS: A total of 44 patients (44 eyes) with previous failed filtering surgery were randomized to one of two groups. The both-flaps group comprised 22 patients (22 eyes) with trabeculectomy and intraoperative mitomycin C application under conjunctival and scleral flaps, while the subconjunctival group comprised 22 patients (22 eyes) with subconjunctival application of mitomycin C. Particular attention was paid to intraocular pressure (IOP), postoperative medications, visual acuity, filtering bleb appearance, and complications. The mean follow-up time was 38.18 ± 12.48 months. RESULTS: The mean preoperative IOP decreased from 39.1 ± 7.3 mmHg to the postoperative level of 15.6 ± 4.8 mmHg in the both-flaps group (p = 0.014), and from 39.4 ± 8.4 to 18.7 ± 5.8 mmHg in the subconjunctival group (p = 0.018). There was a statistically significant difference in IOP at all follow-up times, except at one week and one month postoperatively. Kaplan-Meier survival analysis showed there was no significant difference in total success rate (complete plus qualified success) between the two groups (p = 0.622, log-rank test). However, the two survival curves for the complete success subgroups (without additional medications) confirmed that mitomycin C applications under both flaps had a higher success rate than subconjunctival application (p = 0.043, log-rank test). No statistically significant difference in medications was present between the two groups, and no severe complications developed in either group. CONCLUSIONS: Trabeculectomy augmented with mitomycin C application at both sites could produce a greater lowering of IOP with low incidence of postoperative complications, and could provide an increased chance of long-term success. The procedure is effective and safe in patients with repeat trabeculectomy.
Dr. Y.A. You, Department of Ophthalmology, First Affiliated Hospital, Wenzhou Medical College, Wenzhou, Zhejiang, China
Classification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
