Mitomycin C primary trabeculectomy with releasable sutures in primary glaucoma

Area of Science:

• Ophthalmology
• Surgical Innovation
• Glaucoma Management

Background:

• Primary glaucoma requires effective surgical intervention to manage intraocular pressure (IOP).
• Trabeculectomy is a common surgical procedure for glaucoma.
• Mitomycin C is an antifibrotic agent used to enhance trabeculectomy success.

Purpose of the Study:

• To assess the impact of mitomycin C and a releasable suture technique on primary trabeculectomy outcomes.
• To compare the efficacy and safety of releasable versus permanent sutures in primary trabeculectomy.
• To evaluate postoperative intraocular pressure, visual acuity, and complication rates.

Main Methods:

• Prospective study of primary glaucoma patients undergoing trabeculectomy with mitomycin C (0.2 mg/mL for 2 minutes).
• Patients were divided into two groups: Group 1 (releasable sutures) and Group 2 (permanent sutures) for scleral flap closure.
• Postoperative IOP, visual acuity, and complications were monitored.

Main Results:

• Both groups showed significant IOP reduction (P <.0001).
• Group 2 (permanent sutures) demonstrated significantly lower early postoperative IOP (P =.01) compared to Group 1 (releasable sutures).
• No significant differences in later IOP measurements or complete success rates (88.8% Group 1 vs. 85.0% Group 2) were observed. No serious complications occurred.

Conclusions:

• Primary trabeculectomy with mitomycin C is effective for IOP reduction in primary glaucoma.
• Releasable sutures offer better early postoperative IOP control compared to permanent sutures.
• The procedure is safe, with no observed serious complications like hypotonous maculopathy.