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Postoperative subconjunctival mitomycin-C injection after non-penetrating glaucoma surgery
Michele Iester1, Emilie Ravinet, André Mermoud
1Hospital Ophtalmique Jules Gonin, University of Lausanne, Switzerland. m_iester@hotmail.com
Summary
Subconjunctival mitomycin C (MMC) injections effectively lowered intraocular pressure in glaucoma patients with failing filtering blebs. This treatment demonstrated safety and promoted further IOP reduction in selected cases.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Pharmacology
Background:
- Glaucoma non-penetrating filtering surgery can fail, leading to uncontrolled intraocular pressure.
- Failing filtering blebs may present with pathological aspects like vascularization or cysts.
- Subconjunctival mitomycin C (MMC) is explored as an adjunct therapy.
Purpose of the Study:
- To assess the efficacy and safety of subconjunctival mitomycin C (MMC) injections.
- To evaluate MMC's impact on intraocular pressure (IOP) in patients with failing glaucoma non-penetrating filtering blebs.
Main Methods:
- Twenty-eight eyes of glaucoma patients with uncontrolled IOP post-non-penetrating filtering surgery were included.
- Subconjunctival MMC injections were administered near the filtering bleb to enhance filtration.
- Local effects and complications of MMC injections were analyzed over a mean follow-up of 6 months.
Main Results:
- A significant reduction in mean intraocular pressure (IOP) from 17 +/- 6.6 mmHg to 13.9 +/- 2.9 mmHg was observed.
- A total of 67 MMC injections were performed, with a mean of 2.9 per patient.
- The primary complication noted was two cases of corneal Dellen, possibly related to MMC.
Conclusions:
- Subconjunctival MMC injections appear safe and effective in selected glaucoma patients.
- This method can promote further postoperative intraocular pressure (IOP) reduction in eyes with failing filtering blebs.
- Preliminary results suggest MMC injections are a viable option for managing refractory glaucoma surgery.