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Non‐penetrating glaucoma surgery augmented with mitomycin C or 5‐fluorouracil in eyes at high risk of failure of filtration surgery: long‐term results
Author(s) -
Choudhary Anshoo,
Wishart Peter K
Publication year - 2007
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/j.1442-9071.2007.01483.x
Subject(s) - medicine , trabeculectomy , glaucoma , intraocular pressure , mitomycin c , surgery , glaucoma surgery , glaucoma medication , ophthalmology
A bstract Purpose: To investigate the long‐term efficacy and safety of non‐penetrating glaucoma surgery (NPGS) augmented with mitomycin C (MMC) or 5‐fluorouracil (5FU) in eyes at high risk of failure of glaucoma filtration surgery. Methods: Prospective study of all eyes, undergoing NPGS with 0.04% MMC (1 to 2 min topical or 0.04 mL subconjunctival injection into the superior fornix) or 5FU (25 mg/mL topically for 5 min). Complete success was an intraocular pressure (IOP) ≤ 21 mmHg on no medication and qualified success an IOP ≤ 21 mmHg with topical medication. An additional criterion for success was a ≥20% drop in IOP or a reduction of at least two medications. Results: Twenty‐three eyes of 22 patients with a mean follow up of 41.4 months were reviewed. Fifteen eyes had failed trabeculectomy and seven had uveitic glaucoma. Mean preoperative IOP reduced from 25.8 ± 7.8 to 15.4 ± 4.9 mmHg at final visit, a mean change of 41%. Median number of preoperative medications decreased from 3 to 0 postoperatively. Cumulative probability of success was 100% at 2 years, 94% at 3 years and 85% at 4 years. No patient developed any long‐term complications. Complete success was achieved in 11 eyes and qualified success in 10 eyes. Two eyes failed and required further surgery. Conclusion: NPGS augmented with small‐volume MMC/5FU provides good long‐term IOP control in eyes at high risk of failure with a lower incidence of complications compared with augmented trabeculectomy and eliminates the need for postoperative bleb or suture manipulation.