title: Comparison of trabeculectomy with mitomycin-C versus medical treatment in moderate stage of steroid induced glaucoma.
abstract: This prospective, comparative and interventional study was done to compare the effects of Trabeculectomy with Mitomycin-C and medical treatment with Timolol maleate 0.5% by controlling IOP (intra ocular pressure) and assessing the visual acuity (VA) and mean sensitivity (MS) of visual field in moderate stage of steroid induced glaucoma and conducted in the Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2004 to June 2009. Sixty eyes of thirty patients with glaucoma due to use of topical steroids for >1 year. IOP range was 22-30 mm of Hg, visual field with (MD) mean deviation >6 to 12 dB and (MS) mean sensitivity >12-21dB, C:D ratio 0.7-0.8 and visual acuity 6/9 to 6/6 were included in this study. At first, topical steroid was stopped. Sample was collected in lottery method. Patients were divided into two groups. In Group I, 30 eyes were treated with Timolol maleate 0.5%. In Group II, 30 eyes were treated surgically by Trabeculectomy with Mitomycin-C. Follow-up were done on 1st POD, after 7 days, 1 month, 3 months and 6 months. Successful IOP control (<15mm of Hg) were achieved in 23 eyes (77%) in Group I and 30 eyes (100%) in Group II and were highly significant (p<0.001). Visual acuity and mean sensitivity also improved more in Group II than the Group I. It was also highly significant (p<0.001). So, Trabeculectomy with mitomycin-C is effective procedure in comparison to medical treatment for steroid induced glaucoma.
authors.affiliation: Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka, Bangladesh. drnazneen@ hotmail.com
authors.forename: N
authors.initials: N
authors.lastname: Khan
authors.forename: M A
authors.initials: MA
authors.lastname: Khaleque
authors.forename: M S
authors.initials: MS
authors.lastname: Hossain
authors.forename: M S
authors.initials: MS
authors.lastname: Islam
authors.forename: M S
authors.initials: MS
authors.lastname: Uddin
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000477:Alkylating Agents / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005901:Glaucoma / Q000139:chemically induced* / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use*; D011446:Prospective Studies; D013256:Steroids / Q000008:administration & dosage / Q000009:adverse effects*; D013999:Timolol / Q000627:therapeutic use*; D014130:Trabeculectomy / Q000379:methods*; D014792:Visual Acuity
chemical_list: D000477:Alkylating Agents; D013256:Steroids; D016685:Mitomycin; D013999:Timolol