Nonpenetrating deep sclerectomy with the use of adjunctive mitomycin C.
OBJECTIVE
To determine whether adjunctive use of mitomycin C (MMC) would increase the success rate of primary nonpenetrating deep sclerectomy with collagen implant.


METHODS
Twenty-six patients (26 eyes) with primary open-angle glaucoma uncontrolled with maximally tolerated medical therapy were randomly assigned to undergo nonpenetrating deep sclerectomy and collagen implant, either with (13 eyes) or without (13 eyes) 0.3 mg/mL of adjunctive MMC for 3 minutes. Intraocular pressure (IOP), number of glaucoma medications, and visual acuity were assessed before and 12 and 24 months after surgery.


RESULTS
The mean age of the study patients was similar in both groups (MMC = 68.1 +/- 8 years, control = 65.8 +/- 6.8 years). At the 12- and 24-month follow-up visits, the mean IOP with or without medications was lower in the MMC group than in the control group (15.6 +/- 3.5 vs 17.2 +/- 3.9 mm Hg at 12 months and 15.8 +/- 5.6 vs 17.8 +/- 2.8 mm Hg at 24 months, respectively). The IOP with or without medications significantly decreased after surgery in both groups (P < .05). Twelve months after surgery, the IOP decreased by 48% in the MMC group and by 35% in the control group. At the end of follow-up (24 months), the IOP decreased by 48% in the MMC group and by 32% in the control group (P = .01). The mean number of glaucoma medications decreased after surgery, there was no significant difference in complications (hyphema and suprachoroidal hemorrhage), and visual acuity was unchanged throughout the study in both groups.


CONCLUSIONS
The use of MMC in nonpenetrating deep sclerectomy with collagen implant is safe and improves surgical results.
Neudorfer
Meira
M
Department of Ophthalmology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Sadetzki
Siegal
S
Anisimova
Svetlana
S
Geyer
Orna
O
D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000187:drug effects; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use*; D011183:Postoperative Complications; D011446:Prospective Studies; D012449:Safety; D012590:Sclera / Q000601:surgery; D012599:Sclerostomy / Q000379:methods*; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin