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1 General aspects (0)   1.1 Epidemiology (6)   1.2 Population genetics (19)   1.3 Pathogenesis (5)   1.4 Quality of life (5)   1.5 Glaucomas as cause of blindness (3)   1.6 Prevention and screening (2) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (0)   2.2 Cornea (3)   2.3 Sclera (1)   2.4 Anterior chamber angle (0)   2.5 Meshwork (8)     2.5.1 Trabecular meshwork (0)     2.5.2 Schlemms canal (0)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (6)     2.6.1 Production (0)     2.6.2 Outflow (0)       2.6.2.1 Trabecular meshwork (0)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (0)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (2)   2.9 Ciliary body (6)   2.10 Lens (0)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (3)   2.13 Retina and retinal nerve fibre layer (24)   2.14 Optic disc (23)   2.15 Optic nerve (0)   2.16 Chiasma and retrochiasmal central nervous system (3)   2.17 Stem cells (0)   2.20 Other (1) 3 Laboratory methods (10)   3.1 Microscopy (0)   3.2 Electron microscopy (0)   3.3 Immunohistochemistry (7)   3.4 Molecular genetics (1)     3.4.1 Linkage studies (0)     3.4.2 Gene studies (0)   3.5 Molecular biology incl. 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    9.4.1 Steroid-induced glaucoma (2)     9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (0)       9.4.2.1 Iridocorneal endothelial syndrome (ICE, incl. irisatrophy) (0)       9.4.2.2 Posterior polymorphous dystrophy (0)       9.4.2.3 Fuchs' endothelial dystrophy (0)       9.4.2.5 Other (0)     9.4.3 Glaucomas associated with disorders of the iris and ciliary body (0)       9.4.3.1 Pigmentary glaucoma (2)       9.4.3.5 Other (0)     9.4.4 Glaucomas associated with disorders of the lens (0)       9.4.4.1 Exfoliation syndrome (4)       9.4.4.2 Glaucomas associated with cataracts (2)       9.4.4.3 Glaucomas associated with lens dislocation (0)       9.4.4.5 Other (0)     9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (0)       9.4.5.1 Neovascular glaucoma (3)       9.4.5.5 Other (0)     9.4.6 Glaucomas associated with inflammation, uveitis (0)     9.4.7 Glaucomas associated with ocular trauma (1)     9.4.8 Glaucomas associated 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Without tube implant (5)     12.8.2 With tube implant or other drainage devices (10)     12.8.3 Non-perforating (8)     12.8.4 Using laser (1)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (20)     12.8.11 Complications, endophthalmitis (10)   12.9 Trabeculotomy, goniotomy (1)   12.10 Cyclodestruction (1)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (0)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (1)     12.12.3 Phacoemulsification (4)   12.14 Combined cataract extraction and glaucoma surgery (0)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (5)   12.15 Capsulotomy (0)   12.16 Vitrectomy (0)   12.17 Anesthesia (0)   12.20 Other (2) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (0)   13.2 Outcome (0)     13.2.1 IOP (0)     13.2.2 Visual field (0)       13.2.2.1 Progression (0)       13.2.2.2 Improvement (0)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (0) 15 Miscellaneous (7)

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Abstract #8470 Published in IGR 5-1

Mitomycin-C-augmented trabeculectomy for neovascular glaucoma: a preliminary report

Mandal AK; Majji AB; Mandal SP; Das T; Jalali S; Gothwal VK; Jain SS; Nutheti R
Indian Journal of Ophthalmology 2002; 50: 287-293

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PURPOSE: This study aimed to investigate the safety and efficacy of trabeculectomy with intraoperative mitomycin C (MMC) in the management of eyes with neovascular glaucoma (NVG). METHODS: Fifteen eyes of 14 patients with NVG were included in the study. NVG was secondary to central retinal vein occlusion (three eyes), hemiretinal vein occlusion (two eyes), proliferative diabetic retinopathy (eight eyes), branch retinal vein occlusion (one eye), and idiopathic (one eye). Preoperative retinal ablation was performed in eyes with evidence of posterior segment ischemia. Following this, all eyes underwent trabeculectomy with intraoperative MMC (0.4 mg/ml for three minutes). Clinical outcome assessment included visual acuity, intraocular pressure (IOP), bleb appearance, identification of complications and antiglaucoma medications required to control IOP. RESULTS: The mean IOP decreased from 38.6 ± 12.9 mmHg (range, 15-64 mmHg) to 17.4 ± 9.33 mmHg (range, 4-34 mmHg) (p = 0.001). Preoperative visual acuity ranged from light perception to 6/9 in the affected eye. Thirteen (86.6%) of 15 eyes improved vision or retained preoperative vision, one (6.7%) eye lost light perception, and one (6.7%) eye developed tractional retinal detachment two years after trabeculectomy. Ten (66.7%) of 15 eyes were classified as surgical success with a mean follow-up of 28.6 ± 26.3 months (range, 2-82 months). None of the patients developed choroidal hemorrhage, hypotony maculopathy, late onset bleb leak or endophthalmitis. CONCLUSION: Trabeculectomy with intraoperative MMC is a good treatment modality in the management of eyes with NVG.

Dr. A.K. Mandal, VST Centre for Glaucoma Care, LV Prasad Eye Institute, LV Prasad Marg, Hyderabad 500 034, India. mandal@lvpeye.stph.net

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Classification:

9.4.5.1 Neovascular glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous)
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)

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