Mitomycin C-augmented deep sclerectomy in primary open-angle glaucoma and exfoliation glaucoma: a three-year prospective study

作者：Ollikainen Minna L^*; Puustjarvi Tuomo J; Rekonen Petri K; Uusitalo Hannu M; Terasvirta Markku E

来源：Acta Ophthalmologica, 2011, 89(6): 548-555.

DOI：10.1111/j.1755-3768.2009.01772.x

• deep sclerectomy
• exfoliation glaucoma
• mitomycin C
• non-penetrating surgery
• open-angle glaucoma

Purpose: To investigate the efficacy and safety of mitomycin C (MMC)-augmented deep sclerectomy with implant (DSCI) in primary open-angle glaucoma (POAG) and exfoliation glaucoma (ExG) patients.
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 goniopuncture treatments and complications were compared postoperatively after 36-month follow-up. Surgery was considered as a complete success when IOP was < 18 mmHg without antiglaucoma medication.
Results: Preoperatively the mean IOPs were 23 +/- 6 mmHg and 25 +/- 8 mmHg, and 13 +/- 4 mmHg and 11 +/- 4 mmHg in the POAG and ExG groups, respectively, at 36 months. At 36 months, 74% and 73% of surgeries were a complete success in the POAG and ExG group, respectively [not significant (NS)]. Two patients (8%) of the POAG group and one of the ExG group (3%) were receiving antiglaucoma medication at 36 months (NS). Nd: YAG laser goniopuncture was performed more often in the ExG group (87%) than in the POAG group (61%, p = 0.024). Postoperatively choroidal detachment occurred in 16% of eyes in the POAG group and in 11% of eyes in the ExG group (NS).
Conclusions: DSCI with MMC augmentation appears to be as effective in patients with ExG and POAG in lowering IOP to target levels at medium term with few immediate postoperative complications.

• 出版日期2011-9