Clinical Study
Eye (2007) 21, 23–28. doi:10.1038/sj.eye.6702183; published online 25 November 2005
Deep sclerectomy with mitomycin C in failed trabeculectomy
None of the authors has a financial or proprietary interest in any material or method mentioned
G Rebolleda1 and F J Muñoz-Negrete1
1Glaucoma Unit, Ophthalmology Department, Hospital Ramón y Cajal, University of Alcala, Madrid, Spain
Correspondence: G Rebolleda, Glaucoma Unit, Ophthalmology Department, Hospital Ramón y Cajal, Carretera Colmenar Viejo, km 9.1, Madrid E 28034, Spain. Tel: +34 913369023; Fax: +34 913369023; E-mail: grebolleda@ telefonica.net
Received 31 July 2005; Accepted 29 September 2005; Published online 25 November 2005.
Abstract
Aim
To evaluate the success rate and complications associated with deep sclerectomy with mitomycin C (MMC) and a reticulated hyaluronic acid implant in previously failed trabeculectomy.
Methods
This prospective study included 20 eyes with a previously failed trabeculectomy, which were treated with deep sclerectomy with 0.2 mg/ml MMC application under the conjunctiva and superficial scleral flap. Intraocular pressure (IOP), glaucoma medications, visual acuity, and complications were recorded preoperatively and 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively.
Results
The mean preoperative IOP was 25.8
7.3 mmHg; the IOP significantly decreased to 14.63.2 mmHg 1 year postoperative. At each interval, the mean IOP was significantly lower than preoperatively (P=0.000). At 1 year, the complete success rate (IOP
21 mmHg untreated) was 65% and the qualified success rate (IOP21 mmHg with and without medication) was 100%. 12 patients (60%) achieved an IOP15 mmHg with and without medication. No shallow or flat anterior chamber, endophthalmitis, or leakage developed.
Conclusions
These data suggest that deep sclerectomy augmented with MMC is a safe surgical procedure that decreases IOP in eyes with a previously failed trabeculectomy.
Keywords:
deep sclerectomy, glaucoma surgery, nonperforating surgery, failed trabeculectomy, mitomycin C
