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Intraoperative injection versus sponge-applied mitomycin C during trabeculectomy: One-year study.

Devendra Maheshwari¹, Swathi Kanduri¹, Ramakrishnan Rengappa¹

¹Department of Glaucoma, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.

Indian Journal of Ophthalmology

|March 17, 2020

Summary

Mitomycin C (MMC) injection and sponge methods show comparable success in trabeculectomy for glaucoma patients. MMC injection may be a safer alternative, with fewer complications than the sponge method.

Keywords:

Injectable mitomycin C sponge soaked mitomycin C trabeculectomy

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Area of Science:

Ophthalmology
Glaucoma Surgery
Pharmacology

Background:

Trabeculectomy is a surgical procedure to manage glaucoma by reducing intraocular pressure (IOP).
Mitomycin C (MMC) is an antifibrotic agent used during trabeculectomy to enhance surgical success.
The application method of MMC (injection vs. sponge) may influence its efficacy and safety profile.

Purpose of the Study:

To compare the safety and efficacy of mitomycin C (MMC) injection versus the conventional sponge method during trabeculectomy.
To evaluate the long-term outcomes, including IOP control and complication rates, for both MMC application techniques.

Main Methods:

A prospective analysis of 42 patients undergoing trabeculectomy with MMC for glaucoma.
Patients were divided into two groups: MMC injection (n=21) and MMC sponge (n=21).
Follow-up was conducted for one year to assess IOP, medication use, success rates, and complications.

Main Results:

Both groups showed significant IOP reduction (P < 0.001) and decreased medication use.
The complete success rate at one year was higher in the MMC injection group (52.4%) compared to the sponge group (26.1%).
Overall success rates were comparable (90.5% vs. 87%). Major complications, including choroidal detachment and malignant glaucoma, occurred only in the sponge group.

Conclusions:

Mitomycin C (MMC) injection appears to be as safe and effective as the conventional sponge application for trabeculectomy.
The injection method may offer a comparable complete treatment success rate with a potentially improved safety profile.
Further research may support MMC injection as a viable alternative in glaucoma surgery.