title: Ab-externo cyclodialysis enhanced trabeculectomy for intractable post-penetrating keratoplasty glaucoma.
abstract: OBJECTIVE
  To evaluate the efficacy of cyclodialysis-enhanced Mitomycin c (MMC) trabeculectomy in post-keratoplasty glaucoma.
  
  
  METHODS
  Prospective, non-comparative, interventional case series.
  
  
  METHODS
  A total of 45 eyes of 45 consecutive patients with refractory glaucoma after penetrating glaucoma underwent a cyclodialysis-augmented trabeculectomy with MMC. The visual acuity, intraocular pressure (IOP), corneal clarity, and graft failure were evaluated over a minimum follow-up of 2 years.
  
  
  RESULTS
  The mean age of the patients was 55.4+/-9.4 years. The cyclodialysis-augmented MMC trabeculectomy procedure resulted in a mean reduction of IOP from 38.9+/-3.9 mmHg (95% confidence interval (CI) 35.9-42.2) at baseline to 11.3+/-2.8 mmHg (95% CI 9.5-12.9), at final follow up (P=0.002). Blebs were avascular, diffuse, and extended posteriorly. Postoperative UBMs revealed the presence of a cyclodialysis with a small associated suprachoroidal effusion and a subconjunctival filtering bleb in all cases.
  
  
  CONCLUSIONS
  Cyclodialysis-augmented MMC trabeculectomy provides a safe and effective method of lowering IOP in intractable glaucoma following penetrating keratoplasty, without compromising the corneal graft survival and clarity.
authors.affiliation: Glaucoma research facility & clinical services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. rjsihota@hotmail.com
authors.forename: R
authors.initials: R
authors.lastname: Sihota
authors.forename: G
authors.initials: G
authors.lastname: Srinivasan
authors.forename: V
authors.initials: V
authors.lastname: Gupta
mesh_terms: D003315:Cornea / Q000473:pathology; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D007429:Intraocular Pressure; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D011446:Prospective Studies; D014130:Trabeculectomy / Q000379:methods*; D014792:Visual Acuity
chemical_list: D016685:Mitomycin