Mitomycin-C-augmented deep sclerectomy in patients with primary open-angle glaucoma and exfoliation glaucoma: a 1-year prospective study.
OBJECTIVE
To investigate the efficacy and safety of mitomycin C (MMC)-augmented deep sclerectomy with implant (DSCI) in patients with primary open-angle glaucoma (POAG) and exfoliation glaucoma (ExG).


METHODS
A total of 68 eyes of 68 patients with POAG and ExG were enrolled consecutively to undergo DSCI with MMC (0.4 mg/ml for 2 min). The intraocular pressure (IOP), number of antiglaucoma medications, neodymium:yttrium-aluminum-garnet (Nd:YAG) laser goniopunctures and complications were compared postoperatively. Surgery was considered as a complete success when IOP was < 18 mmHg without antiglaucoma medication.


RESULTS
Preoperatively, the mean IOPs were 23.1 +/- 5.8 and 25.4 +/- 8.3 mmHg, and 13.8 +/- 6.1 and 11.2 +/- 5.6 mmHg in the POAG and ExG groups, respectively, at 12 months. 77.4% and 75.7% of surgeries were a complete success in the POAG and ExG groups, respectively [not significant (NS)]. Five patients (16.1%) in the POAG group but none in the ExG group (0%) were receiving antiglaucoma medication at 12 months (NS). Nd:YAG laser goniopuncture was performed in 29.0% of eyes in the POAG group and in 55.6% of eyes in the ExG group (p = 0.047). Postoperatively, choroidal detachment occurred in 16.1% of eyes in the POAG group and in 10.8% of eyes in the ExG group (NS). We encountered no serious complications related to MMC use.


CONCLUSIONS
DS with MMC augmentation appears to be equally effective in ExG and POAG patients in lowering IOP to target levels, at least in the short term, with few immediate postoperative complications.
Department of Ophthalmology, Kuopio University Hospital, Finland. minna.ollikainen@kuh.fi
Minna
M
Ollikainen
Tuomo
T
Puustjärvi
Petri
P
Rekonen
Hannu
H
Uusitalo
Markku
M
Teräsvirta
D020341:Absorbable Implants; D000368:Aged; D000867:Anterior Chamber / Q000601:surgery; D015862:Choroid Diseases / Q000209:etiology; D003094:Collagen / Q000008:administration & dosage; D004343:Drug Implants; D017889:Exfoliation Syndrome / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care; D053208:Kaplan-Meier Estimate; D053685:Laser Therapy; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage* / Q000009:adverse effects; D011183:Postoperative Complications; D011446:Prospective Studies; D011677:Punctures; D012086:Reoperation; D012599:Sclerostomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
D004343:Drug Implants; D016685:Mitomycin; D003094:Collagen