Semiconductor diode laser transscleral cyclophotocoagulation versus filtering surgery with Mitomycin-C.
Both filtering surgery with Mitomycin-C and diode laser cyclophotocoagulation have proved to be effective alternatives in cases of glaucoma with poor surgical prognosis. The right eyes of 40 pigmented rabbits were randomly divided into 2 groups: Mitomycin-C group underwent filtering surgery with application of 0.4 mg/ml of Mitomycin-C whereas the diode laser (DL) group received 15 applications of 1.8 J (1800 mW. 1000 ms) distributed in 270 degrees. Mean IOP showed statistical differences in two periods between days 3-13 and 45-60-Mann-Whitney U test -with a higher IOP lowering in the DL group. The comparison of IOP survival curves (Log-Rank test) was not significant p = 0.070809. Ocular hypertension, hyphema and inflammatory signs were higher in the DL group, both in short and long term, but in terms of statistical significance only ocular hypertension showed differences p = 0.00011717-Fisher exact test. Microscopic examination revealed patent sclerostomies in 60% of the MMC group eyes with different grades of fibroblastic proliferation. In the DL group we observed necrosis of the scleral stroma and of the pigmented and unpigmented ciliary epithelium, with signs of thermal coagulation of the ciliary stroma and of the stromal vasculature. We must point out that the treatment with laser has proved to be more effective although both treatments showed very acceptable IOP lowering until 2 months after the surgery.
Pablo
L E
LE
Department of Ophthalmology, Miguel Servet Hospital, Zaragoza, Spain.
Gómez
M L
ML
Pueyo
M
M
Ramírez
T
T
Torrón
C
C
Melcón
B
B
Ruiz
O
O
Honrubia
F M
FM
D000287:Administration, Topical; D000818:Animals; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D002924:Ciliary Body / Q000187:drug effects / Q000601:surgery*; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery; D007429:Intraocular Pressure; D017075:Laser Coagulation; D016685:Mitomycin / Q000008:administration & dosage*; D009883:Ophthalmic Solutions; D011183:Postoperative Complications; D011379:Prognosis; D011817:Rabbits; D012590:Sclera / Q000187:drug effects / Q000601:surgery*; D014130:Trabeculectomy / Q000379:methods*
D000903:Antibiotics, Antineoplastic; D009883:Ophthalmic Solutions; D016685:Mitomycin