Combined phacoemulsification and deep sclerectomy (PDS) with intraoperative mitomycin C (MMC) augmentation

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Innovation

Background:

• Phacoemulsification and deep sclerectomy (PDS) is a surgical procedure for glaucoma management.
• Mitomycin C (MMC) is an antifibrotic agent used in ophthalmic surgery.
• Optimizing intraocular pressure (IOP) control after PDS is crucial for long-term glaucoma management.

Purpose of the Study:

• To evaluate the safety and efficacy of intraoperative mitomycin (MMC) augmentation in combined phacoemulsification and deep sclerectomy (PDS).
• To compare IOP reduction and surgical outcomes between PDS with and without MMC augmentation.

Main Methods:

• Retrospective, non-randomized, comparative interventional case series.
• 119 eyes of 119 patients undergoing PDS between September 2001 and April 2004.
• Comparison of outcomes between eyes augmented with MMC (PDS-MMC) and those without (PDS-no MMC).

Main Results:

• Two-year postoperative IOP below 19 mmHg was achieved in 76% of PDS-MMC eyes vs. 62% of PDS-no MMC eyes (P=0.02).
• Two-year postoperative IOP below 15 mmHg was achieved in 62% of PDS-MMC eyes vs. 45% of PDS-no MMC eyes (P=0.04).
• No significant differences in Nd:YAG laser goniopuncture, needle revision rates, or visual acuity loss; minimal MMC-related complications observed.

Conclusions:

• Intraoperative MMC augmentation of PDS is a safe adjunctive treatment.
• MMC augmentation enhances the probability of achieving target lower intraocular pressures after PDS.
• This approach may improve long-term IOP control in glaucoma patients undergoing PDS.