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Mitomycin-C-augmented trabeculectomy for neovascular glaucoma. A preliminary report
Anil K Mandal1, Ajit B Majji, Soma P Mandal
1VST Centre for Glaucoma Care, L V Prasad Eye Institute, L V Prasad Marg, Banjara Hills, Hyderabad 500 034, India. mandal@lvpeye.stph.net
Indian Journal of Ophthalmology
|January 21, 2003
Summary
Trabeculectomy with mitomycin C (MMC) effectively lowers intraocular pressure in neovascular glaucoma (NVG) patients. This surgical approach offers a promising treatment option for managing this severe form of glaucoma.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Surgical Innovation
Background:
- Neovascular glaucoma (NVG) is a severe condition often associated with poor visual outcomes.
- Effective management strategies for NVG are crucial due to its complex etiology and resistance to conventional treatments.
Purpose of the Study:
- To evaluate the safety and efficacy of trabeculectomy combined with intraoperative mitomycin C (MMC) for treating neovascular glaucoma (NVG).
Main Methods:
- The study included 15 eyes of 14 patients diagnosed with NVG, secondary to various conditions like retinal vein occlusion and diabetic retinopathy.
- Preoperative retinal ablation was performed for posterior segment ischemia, followed by trabeculectomy with intraoperative MMC (0.4 mg/ml for 3 minutes).
- Outcomes assessed included visual acuity, intraocular pressure (IOP), bleb appearance, complications, and need for antiglaucoma medications.
Main Results:
- Mean IOP significantly decreased from 38.6 mmHg to 17.4 mmHg (P = 0.001).
- Vision improved or was maintained in 86.6% of eyes; 66.7% achieved surgical success at a mean follow-up of 28.6 months.
- No cases of choroidal hemorrhage, hypotony maculopathy, late bleb leak, or endophthalmitis were reported.
Conclusions:
- Trabeculectomy with intraoperative MMC demonstrates a favorable safety and efficacy profile for managing NVG.
- This surgical intervention represents a valuable treatment option for patients suffering from neovascular glaucoma.