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Deep sclerectomy with and without mitomycin‐C in normal tension glaucoma
Author(s) -
SUOMINEN S,
HARJU M,
KURVINEN L,
IHANAMäKI T,
VESTI E
Publication year - 2010
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/j.1755-3768.2010.3155.x
Subject(s) - medicine , intraocular pressure , glaucoma , mitomycin c , ophthalmology , visual acuity , dry needling , surgery , normal tension glaucoma , anesthesia , open angle glaucoma , acupuncture , alternative medicine , pathology
Purpose To study the effect of deep sclerectomy (DS) with and without Mitomycin‐C(MMC) on intraocular pressure (IOP) in normal tension glaucoma (NTG) patients. Methods We prospectively analysed the results of 29 eyes of 29 consecutive NTG patients (mean ±SD age, 62,9 ±7,0 years ) to whom DS was performed. Patients were randomized to the Mitomycin‐C and non‐MMC groups. MMC (0.4 mg/ml for 3 minutes) was used in 12 of 29 eyes. Results There was a significant reduction from the preoperative IOP (mean, ±SD; 15,5 mmHg, ±2,8) to the postoperative IOP after 12 months follow‐up (11,1, ±2,0 mmHg, p<0,001). In MMC group the mean postoperative IOP after 12 months was 10,3, ±1,9 mmHg and in non‐MMC group 11,7 ±1,9 mmHg. This difference was not statistically significant (p=0,053). Total success, a 25% reduction in IOP without medication, was achieved in 15/29 eyes (7/12 in MMC group and 8/17 in non‐MMC group). At the end of 12 months follow‐up 19 eyes (66%) were without glaucoma medication. Goniopuncture was performed in 19 eyes (66%) and needling in 6 eyes (21%). Complications included loss of two or more snellen lines in visual acuity (6 eyes), microperforation (3), re‐suturation of con‐junctiva (4) and dellen formation (2). Conclusion Clinically and statistically significant IOP reduction was achieved. There is a trend towards even lower postoperative IOP when MMC is used. DS seems to be effective and safe in reducing IOP during 12 months follow‐up in NTG patients.