title: Deep sclerectomy with mitomycin C for glaucoma secondary to uveitis.
abstract: OBJECTIVE
  To report outcomes of deep sclerectomy augmented with mitomycin C (MMC) in eyes with raised intraocular pressure (IOP) secondary to uveitis.
  
  
  METHODS
  This was a retrospective case series of 26 eyes of 26 patients with uveitic glaucoma. Mitomycin C 0.2-0.4 mg/mL was applied subconjunctivally prior to scleral flap dissection for 2-3 minutes.
  
  
  RESULTS
  Mean follow-up was 46.5±22 months (range 12-83). Fifteen eyes (58%) had previous intraocular surgery. Preoperative IOP was 33±12 mmHg. Intraocular pressure at 1, 2, and 3 years after surgery was 13±4 mmHg, 13±4 mmHg, and 14±4 mmHg, respectively. The probability of IOP <21 and 18 mmHg with needle revision and laser goniopuncture but without medications or further glaucoma procedure was 89% and 84%, respectively, at 3 years. The cumulative probability for performing laser goniopuncture was 42% at 1 year, 50% at 2 years, and 64% at 3 years. Needle revision was performed in 6 eyes (23%). Three (12%) patients required further glaucoma surgery. The number of glaucoma medications decreased from 3.3±1.2 to 0.3±0.8 by last follow-up (p<0.001). Four eyes (15%) were on medications to control IOP. Intraoperative perforation of trabeculo-Descemetic membrane occurred in 3 eyes (12%) and late iris entrapment in perforation or goniopuncture in 4 eyes (15%). Recurrence of uveitis was seen in 11 eyes (42%) with no loss in IOP control.
  
  
  CONCLUSIONS
  Deep sclerectomy with MMC appears to be a safe and effective procedure to lower IOP in uveitic glaucoma with a low rate of complications.
authors: Department of Ophthalmology, Calderdale and Huddersfield NHS Trust, West Yorkshire, United Kingdom. anand1604@gmail.com
authors: Nitin
authors: N
authors: Anand
mesh_terms: D000477:Alkylating Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D012008:Recurrence; D012189:Retrospective Studies; D012590:Sclera / Q000601:surgery*; D012599:Sclerostomy; D016896:Treatment Outcome; D014605:Uveitis / Q000150:complications* / Q000503:physiopathology
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin