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Deep sclerectomy with mitomycin C in failed trabeculectomy.

G Rebolleda1, F J Muñoz-Negrete

  • 1Glaucoma Unit, Ophthalmology Department, Hospital Ramón y Cajal, University of Alcala, Madrid, Spain. grebolleda@telefonica.net

Eye (London, England)
|November 29, 2005
PubMed
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Deep sclerectomy with mitomycin C (MMC) successfully lowered intraocular pressure (IOP) in patients with prior failed glaucoma surgery. This safe procedure achieved significant IOP reduction and high success rates at one year post-operation.

Area of Science:

  • Ophthalmology
  • Glaucoma Surgery

Background:

  • Trabeculectomy is a common glaucoma surgery, but failure can necessitate further intervention.
  • Recurrent elevated intraocular pressure (IOP) after initial glaucoma surgery poses a significant clinical challenge.

Purpose of the Study:

  • To assess the efficacy and safety of deep sclerectomy combined with mitomycin C (MMC) and a hyaluronic acid implant in eyes with previously failed trabeculectomy.
  • To evaluate the long-term intraocular pressure (IOP) reduction and complication rates of this surgical approach.

Main Methods:

  • A prospective study involving 20 eyes with a history of failed trabeculectomy.
  • Deep sclerectomy was performed with subconjunctival mitomycin C (MMC) application and a superficial scleral flap.
  • Intraocular pressure (IOP), medication use, visual acuity, and complications were monitored for 12 months postoperatively.

Related Experiment Videos

Main Results:

  • Mean preoperative IOP of 25.8 mmHg decreased significantly to 14.6 mmHg at 1 year postoperative (P=0.000).
  • Complete success (untreated IOP ≤ 21 mmHg) was 65%, and qualified success (IOP ≤ 21 mmHg with or without medication) was 100% at 1 year.
  • 60% of patients achieved an IOP ≤ 15 mmHg, with no reported cases of shallow/flat anterior chamber, endophthalmitis, or leakage.

Conclusions:

  • Deep sclerectomy augmented with MMC is a safe and effective surgical option for reducing IOP in eyes with previously failed trabeculectomy.
  • The procedure demonstrates a favorable safety profile with significant IOP lowering and high success rates.