Deep sclerectomy with mitomycin C for glaucoma secondary to uveitis

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Interventions

Background:

• Uveitic glaucoma presents a significant challenge in managing intraocular pressure (IOP).
• Traditional treatments may be insufficient for controlling IOP in these complex cases.
• Deep sclerectomy augmented with mitomycin C (MMC) is explored as a potential therapeutic option.

Purpose of the Study:

• To evaluate the outcomes of deep sclerectomy combined with mitomycin C (MMC).
• To assess the efficacy and safety of this procedure in eyes with uveitic glaucoma.
• To determine the long-term IOP control and complication rates.

Main Methods:

• A retrospective case series involving 26 eyes of 26 patients diagnosed with uveitic glaucoma.
• Subconjunctival application of mitomycin C (0.2-0.4 mg/mL) for 2-3 minutes before scleral flap dissection.
• Follow-up duration averaged 46.5 months, with IOP measurements and surgical intervention records analyzed.

Main Results:

• Postoperative IOP significantly decreased, with mean IOP at 1, 2, and 3 years being 13±4 mmHg, 13±4 mmHg, and 14±4 mmHg, respectively.
• High probability of IOP control (<21 mmHg and <18 mmHg) was achieved by 3 years (89% and 84%) without additional medications or procedures.
• The need for glaucoma medications decreased substantially, and complication rates, including intraoperative perforation and late iris entrapment, were relatively low.

Conclusions:

• Deep sclerectomy augmented with mitomycin C demonstrates significant efficacy in reducing IOP for patients with uveitic glaucoma.
• The procedure is associated with a favorable safety profile and a low incidence of complications.
• This surgical technique offers a viable and effective long-term solution for managing intraocular pressure in uveitic glaucoma.