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Subconjunctival versus intrascleral mitomycin-C in trabeculectomy
C S Tressler1, M N Cyrlin, J S Rosenshein
1Sinai Hospital, Detroit, MI, USA.
Ophthalmic Surgery and Lasers
|August 1, 1996
Summary
Intrascleral mitomycin-C (MMC) during trabeculectomy did not improve outcomes over sub-Tenon's MMC. Both methods lowered intraocular pressure (IOP), but intrascleral MMC required more follow-up surgeries.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Glaucoma Research
Background:
- Trabeculectomy is a common glaucoma surgery.
- Mitomycin-C (MMC) is used to enhance surgical success.
- Standard MMC administration is sub-Tenon's.
Purpose of the Study:
- To compare sub-Tenon's vs. intrascleral MMC administration in trabeculectomy.
- To determine if intrascleral MMC is superior to sub-Tenon's MMC.
- To evaluate effects on intraocular pressure (IOP) and surgical outcomes.
Main Methods:
- Randomized prospective study of 24 eyes from 23 patients.
- MMC (0.27 mg/ml for 5 minutes) administered via sub-Tenon's (Group A) or intrascleral (Group B) route.
- Comparison of visual acuity, IOP, medication needs, and complications.
Main Results:
- No significant preoperative differences in VA, IOP, or medications.
- Both groups showed significant postoperative IOP and medication reduction.
- Group B (intrascleral) required significantly more postoperative procedures (14 vs. 3).
Conclusions:
- Both sub-Tenon's and intrascleral MMC effectively reduce IOP post-trabeculectomy.
- Intrascleral MMC administration led to a higher need for subsequent surgical interventions.
- Sub-Tenon's MMC remains a viable and potentially less intervention-prone method.