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Abstract #59395 Published in IGR 16-3
Application of mitomycin in primary covered sclerotomy
Karioris E; Wirbelauer C; Häberle H; Pham DTKlinische Monatsblätter für Augenheilkunde 2014; 231: 1012-1015
BACKGROUND: The covered sclerotomy is a minimally invasive, standardized fistulating glaucoma surgical procedure with reduced risk of complications. Early postoperative bleb fibrosis is a main success-limiting problem. In this clinical study IOP follow-up and the one year success rate after primary application of mitomycin C (MMC) is analyzed. PATIENTS AND METHODS: In 76 eyes with advanced glaucoma and without previous fistulating surgery, a covered sclerotomy combined with 3-minute-application of MMC0,02 % was performed. Over a period of 12 months, bleb and pressure were controlled regularly. The success rates were compared primarily with data from an earlier study without application of MMC. RESULTS: The mean age of the patients was 70 ± 11 years. 45 % had a pseudoexfoliation syndrome while 41 % were pseudophakic. The mean intraocular pressure (IOP) was 27 ± 8,5 mmHg preoperatively. After 12 months it was 16,2 ± 4,3 mmHg (p < 0.05) with a mean IOP reduction of 40 %. The absolute success rate (intraocular pressure < 21 mmHg without antiglaucoma therapy) was 58 % and the relative success rate (intraocular pressure < 21 mmHg under treatment) was 71 %. A revision or a needling was performed in 22 eyes (29 %). MMC-related complications were not observed. CONCLUSION: Through the additional MMC application on the base of the primary covered sclerotomy a significant pressure reduction could be achieved. 58 % of the patients didn't need any glaucoma medicine. The absolute success rate was higher than without additional inhibitions of the fibrosis.
Klinik für Augenheilkunde, Vivantes Klinikum Neukölln, Berlin.
Full articleClassification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
