Deep sclerectomy-trabeculectomy with mitomycin C in treating glaucoma: postoperative long-term results

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Outcomes

Background:

• Glaucoma management requires effective surgical interventions to reduce intraocular pressure (IOP).
• Deep sclerectomy-trabeculectomy (DST) is a surgical option for glaucoma.
• Mitomycin C (MMC) is an antifibrotic agent used in glaucoma surgery.

Purpose of the Study:

• To evaluate the long-term postoperative outcomes of deep sclerectomy-trabeculectomy (DST) combined with mitomycin C (MMC).
• To assess the efficacy and safety of DST with MMC in glaucoma treatment over an extended period.

Main Methods:

• Retrospective observational study of 98 eyes undergoing DST with MMC (2010-2017).
• Defined complete success as postoperative IOP ≤21 mm Hg or 30% reduction without topical agents.
• Assessed IOP, best corrected visual acuity (BCVA), and Humphrey visual field (HVF) mean deviation (MD) at follow-up.
• Used mixed linear regression to analyze predictive factors.

Main Results:

• Mean IOP reduction was observed throughout the follow-up period (mean 67.5 months).
• 85.7% of eyes achieved complete surgical success.
• BCVA and MD were maintained; IOP-lowering medications reduced significantly.
• Transient hyphaema and choroidal effusion were the most common complications; no endophthalmitis or macular edema occurred.

Conclusions:

• Deep sclerectomy-trabeculectomy with mitomycin C provides effective and sustained IOP reduction in glaucoma patients.
• The procedure is associated with a low rate of major complications.
• DST with MMC is a viable long-term surgical treatment for glaucoma.