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Deep sclerectomy in normal‐tension glaucoma with and without mitomycin‐c
Author(s) -
Suominen Sakari,
Harju Mika,
Kurvinen Leena,
Vesti Eija
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.12305
Subject(s) - medicine , mitomycin c , intraocular pressure , glaucoma , ophthalmology , normal tension glaucoma , surgery , implant , open angle glaucoma
Purpose To compare the outcome of deep sclerectomy ( DS ) with and without mitomycin‐C ( MMC ) in patients with normal‐tension glaucoma ( NTG ). Methods We prospectively analysed the results of 37 eyes of 37 consecutive patients with NTG (age; mean ± SD ; 64 ± 7 years) who underwent DS with a collagen implant. Patients were randomized to the MMC and non‐ MMC groups. Subconjunctival MMC (0.4 mg/ml for 3 min) was used intraoperatively in 15 of 37 eyes. We defined total success as 25% reduction in intraocular pressure ( IOP ) without medication. Follow‐up time was 12 months. Results The mean preoperative IOP was significantly reduced from 15.2 ± 2.8 mmHg to 9.3 ± 2.7 (p < 0.001) in the MMC group after 12‐month follow‐up and from 15.1 ± 2.9 mmHg to 11.8 ± 2.0 (p < 0.001) in the non‐ MMC group. At 12 months, the mean IOP was significantly lower in the MMC group (p = 0.003) compared with the non‐ MMC group. Total success was achieved in 10 of 15 eyes (67%) in MMC group and in nine of 22 eyes (41%) in non‐ MMC group (p = 0.12). The number of glaucoma medications was decreased from 2.2 ± 0.8 to 0.5 ± 1.2 in MMC group (p = 0.001) and from 2.6 ± 1.0 to 0.5 ± 0.7 in non‐ MMC group (p < 0.001). Goniopuncture was performed in seven eyes (47%) in the MMC group, compared with 16 eyes (73%) in the non‐ MMC group (p = 0.13). IOP < 10 mmHg was achieved in seven of 15 eyes in the MMC group and in two of 22 in the non‐ MMC group (p = 0.009). Complication rate was low, and no difference between groups was evident. Conclusion Deep sclerectomy seems to be effective and safe in reducing IOP in patients with NTG . Intraoperative use of MMC results in lower postoperative IOP 12‐month postoperatively without increased rate of complications.