Ranibizumab versus mitomycin C in primary trabeculectomy--a pilot study.

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Vascular Endothelial Growth Factor Inhibitors

Background:

• Mitomycin C (MMC) is the standard adjunctive agent in primary trabeculectomy.
• MMC is associated with known complications.
• Anti-vascular endothelial growth factor (anti-VEGF) agents offer a potential alternative.

Purpose of the Study:

• To evaluate the feasibility of using the anti-VEGF agent ranibizumab as an alternative to MMC in primary trabeculectomy.
• To compare the clinical outcomes of ranibizumab versus MMC adjunctive use.

Main Methods:

• Prospective, randomized, open-label study.
• 24 consecutive patients undergoing primary trabeculectomy.
• Comparison of ranibizumab versus MMC (0.4 mg/ml) as adjunctive agents.

Main Results:

• No significant baseline differences between groups.
• Higher intra-ocular pressure (IOP) in the ranibizumab group at 1 month (p=0.002).
• Reduced bleb extent in the ranibizumab group at 6 months (p=0.006).
• Increased need for hypotensive medication in the ranibizumab group at 3 months (p=0.011).

Conclusions:

• While no significant IOP or medication differences were observed at one year, ranibizumab use led to a higher rate of subsequent glaucoma surgeries.
• Ranibizumab may be less effective than MMC in achieving long-term IOP control in primary trabeculectomy.