Cargando…

The Safety and Efficacy of Two-site Phacotrabeculectomy with Mitomycin C under Retrobulbar and Topical Anesthesia

Purpose: To evaluate and compare the safety and efficacy of combined two-site phacoemulsification and trabeculectomy surgery with mitomycin C (MMC) in glaucoma-cataract patients with retrobulbar or topical anesthesia. Patients and methods: A retrospective, nonrandomized review of consecutive phacotr...

Descripción completa

Detalles Bibliográficos
Autores principales: Rodriguez, Raquel, Alburquerque, Rachel, Sauer, Tripper, Batlle, Juan Francisco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4875729/
https://www.ncbi.nlm.nih.gov/pubmed/27231414
http://dx.doi.org/10.5005/jp-journals-10008-1196
_version_ 1782433147917434880
author Rodriguez, Raquel
Alburquerque, Rachel
Sauer, Tripper
Batlle, Juan Francisco
author_facet Rodriguez, Raquel
Alburquerque, Rachel
Sauer, Tripper
Batlle, Juan Francisco
author_sort Rodriguez, Raquel
collection PubMed
description Purpose: To evaluate and compare the safety and efficacy of combined two-site phacoemulsification and trabeculectomy surgery with mitomycin C (MMC) in glaucoma-cataract patients with retrobulbar or topical anesthesia. Patients and methods: A retrospective, nonrandomized review of consecutive phacotrabeculectomy patients with a minimum follow-up time of 6 months, no previous glaucoma surgeries, and a preoperative visual acuity (VA) greater than light perception. The main outcome measures were preoperative and postoperative VA, intraocular pressure (IOP), use of glaucoma medications, and complications. A complete surgical success required an IOP from 6 to 18 mm Hg, no visually devastating complications, no return to surgery, and no use of glaucoma medications. Qualified success allowed the use of up to two glaucoma medications. Anesthesia groups were compared by student t-tests and log rank comparison of Kaplan-Meier survival rates. Results: Eighty-seven eyes (83 patients) met inclusion criteria, with a mean follow-up of 19 ± 12 months (6-57 months). The average eye gained 3.1 ± 4.9 lines of VA, lost 4.0 ± 7.1 mm Hg of IOP, and decreased 1.0 ± 1.3 glaucoma medications. Retrobulbar and topical anesthesia groups had statistically equivalent mean changes in VA (p = 0.910), IOP (p = 0.268), and use of glaucoma medications (p = 0.964). Postoperative complication rates were also statistically similar (p = 0.580). Complete success was greater in the retrobulbar group (p = 0.006), however, qualified success was equivalent in both groups (p = 0.769). Conclusion: Two-site phacotrabeculectomy with MMC in West Indian patients is as safe and effective for glaucoma-cataract patients with topical anesthesia as it is under retrobulbar anesthesia, and without short-term losses in VA and the chance of serious complications from injection. How to cite this article: Rodriguez R, Alburquerque R, Sauer T, Batlle JF. The Safety and Efficacy of Two-site Phacotrabeculectomy with Mitomycin C under Retrobulbar and Topical Anesthesia. J Curr Glaucoma Pract 2016;10(1):7-12.
format Online
Article
Text
id pubmed-4875729
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Jaypee Brothers Medical Publishers
record_format MEDLINE/PubMed
spelling pubmed-48757292016-05-26 The Safety and Efficacy of Two-site Phacotrabeculectomy with Mitomycin C under Retrobulbar and Topical Anesthesia Rodriguez, Raquel Alburquerque, Rachel Sauer, Tripper Batlle, Juan Francisco J Curr Glaucoma Pract Review Article Purpose: To evaluate and compare the safety and efficacy of combined two-site phacoemulsification and trabeculectomy surgery with mitomycin C (MMC) in glaucoma-cataract patients with retrobulbar or topical anesthesia. Patients and methods: A retrospective, nonrandomized review of consecutive phacotrabeculectomy patients with a minimum follow-up time of 6 months, no previous glaucoma surgeries, and a preoperative visual acuity (VA) greater than light perception. The main outcome measures were preoperative and postoperative VA, intraocular pressure (IOP), use of glaucoma medications, and complications. A complete surgical success required an IOP from 6 to 18 mm Hg, no visually devastating complications, no return to surgery, and no use of glaucoma medications. Qualified success allowed the use of up to two glaucoma medications. Anesthesia groups were compared by student t-tests and log rank comparison of Kaplan-Meier survival rates. Results: Eighty-seven eyes (83 patients) met inclusion criteria, with a mean follow-up of 19 ± 12 months (6-57 months). The average eye gained 3.1 ± 4.9 lines of VA, lost 4.0 ± 7.1 mm Hg of IOP, and decreased 1.0 ± 1.3 glaucoma medications. Retrobulbar and topical anesthesia groups had statistically equivalent mean changes in VA (p = 0.910), IOP (p = 0.268), and use of glaucoma medications (p = 0.964). Postoperative complication rates were also statistically similar (p = 0.580). Complete success was greater in the retrobulbar group (p = 0.006), however, qualified success was equivalent in both groups (p = 0.769). Conclusion: Two-site phacotrabeculectomy with MMC in West Indian patients is as safe and effective for glaucoma-cataract patients with topical anesthesia as it is under retrobulbar anesthesia, and without short-term losses in VA and the chance of serious complications from injection. How to cite this article: Rodriguez R, Alburquerque R, Sauer T, Batlle JF. The Safety and Efficacy of Two-site Phacotrabeculectomy with Mitomycin C under Retrobulbar and Topical Anesthesia. J Curr Glaucoma Pract 2016;10(1):7-12. Jaypee Brothers Medical Publishers 2016 2016-05-12 /pmc/articles/PMC4875729/ /pubmed/27231414 http://dx.doi.org/10.5005/jp-journals-10008-1196 Text en Copyright © 2016; Jaypee Brothers Medical Publishers (P) Ltd. This work is licensed under a Creative Commons Attribution 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by/3.0/
spellingShingle Review Article
Rodriguez, Raquel
Alburquerque, Rachel
Sauer, Tripper
Batlle, Juan Francisco
The Safety and Efficacy of Two-site Phacotrabeculectomy with Mitomycin C under Retrobulbar and Topical Anesthesia
title The Safety and Efficacy of Two-site Phacotrabeculectomy with Mitomycin C under Retrobulbar and Topical Anesthesia
title_full The Safety and Efficacy of Two-site Phacotrabeculectomy with Mitomycin C under Retrobulbar and Topical Anesthesia
title_fullStr The Safety and Efficacy of Two-site Phacotrabeculectomy with Mitomycin C under Retrobulbar and Topical Anesthesia
title_full_unstemmed The Safety and Efficacy of Two-site Phacotrabeculectomy with Mitomycin C under Retrobulbar and Topical Anesthesia
title_short The Safety and Efficacy of Two-site Phacotrabeculectomy with Mitomycin C under Retrobulbar and Topical Anesthesia
title_sort safety and efficacy of two-site phacotrabeculectomy with mitomycin c under retrobulbar and topical anesthesia
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4875729/
https://www.ncbi.nlm.nih.gov/pubmed/27231414
http://dx.doi.org/10.5005/jp-journals-10008-1196
work_keys_str_mv AT rodriguezraquel thesafetyandefficacyoftwositephacotrabeculectomywithmitomycincunderretrobulbarandtopicalanesthesia
AT alburquerquerachel thesafetyandefficacyoftwositephacotrabeculectomywithmitomycincunderretrobulbarandtopicalanesthesia
AT sauertripper thesafetyandefficacyoftwositephacotrabeculectomywithmitomycincunderretrobulbarandtopicalanesthesia
AT batllejuanfrancisco thesafetyandefficacyoftwositephacotrabeculectomywithmitomycincunderretrobulbarandtopicalanesthesia
AT rodriguezraquel safetyandefficacyoftwositephacotrabeculectomywithmitomycincunderretrobulbarandtopicalanesthesia
AT alburquerquerachel safetyandefficacyoftwositephacotrabeculectomywithmitomycincunderretrobulbarandtopicalanesthesia
AT sauertripper safetyandefficacyoftwositephacotrabeculectomywithmitomycincunderretrobulbarandtopicalanesthesia
AT batllejuanfrancisco safetyandefficacyoftwositephacotrabeculectomywithmitomycincunderretrobulbarandtopicalanesthesia