Intraoperative injection versus sponge-applied mitomycin C during trabeculectomy: One-year study.

To determine the safety and efficacy of mitomycin C (MMC) injection versus sponge during trabeculectomy. It is a prospective analysis of patients who underwent trabeculectomy with MMC and followed up for 1 year, divided into two groups, namely, group 1- injection (n = 21), group 2-> sponge (n = 21). The same concentration of MMC was used for both groups. Inclusion criteria were trabeculectomies with MMC for intraocular pressure (IOP) control in eyes with glaucoma (primary + secondary) with a follow-up of 1 year. Mean preoperative IOP in group 1 was 29.00 ± 11.92 mmHg and group 2 was 25.87 ± 11.09 mmHg, which reduced to 12.19 ± 4.03 and 15.56 ± 10.72 mmHg at final visit with P value of 0.0002 and 0.001, respectively. Mean preoperative number of antiglaucoma medications was 2.4 ± 0.87 in group 1 and 2.3 ± 0.96 in group 2, which reduced to 0.38 ± 0.5 and 0.91 ± 0.85 with P value of 0.001 and 0.0003, respectively. The complete success rate was 52.4% in the injection group and 26.1% in the sponge group at end of 1 year. Overall, success rate (complete + qualified) was 90.5% and 87% in group 1 and group 2 at final visit. All major complications were encountered in sponge group. 1 (11.1%) patient developed choroidal detachment and one had malignant glaucoma which got resolved by medical management. 33.3% cases had encapsulated bleb which received bleb needling. 44.4% cases underwent Argon laser suture lysis postoperatively. The MMC injection may be as safe and as effective as conventional sponge application with comparable estimated complete treatment success.

Citation

Devendra Maheshwari, Swathi Kanduri, Ramakrishnan Rengappa, Mohideen Abdul Kadar. Intraoperative injection versus sponge-applied mitomycin C during trabeculectomy: One-year study. Indian journal of ophthalmology. 2020 Apr;68(4):615-619

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PMID: 32174581

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