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Surgical outcomes of repeat trabeculectomy augmented with high dose mitomycin C

PURPOSE: To evaluate the surgical outcomes of repeat trabeculectomy augmented with risk factor adjusted mitomycin C (MMC) exposure in eyes with previous failed trabeculectomy. METHODS: Case records of 38 eyes of 37 patients with previous failed filter who underwent repeat trabeculectomy with MMC wer...

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Autores principales: Rajendrababu, Sharmila, Shroff, Sujani, Patil, Sangeeta Vivek, Uduman, Mohammed Sithiq, Vardhan, Ashok, Krishnadas, S R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324121/
https://www.ncbi.nlm.nih.gov/pubmed/30574901
http://dx.doi.org/10.4103/ijo.IJO_682_18
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author Rajendrababu, Sharmila
Shroff, Sujani
Patil, Sangeeta Vivek
Uduman, Mohammed Sithiq
Vardhan, Ashok
Krishnadas, S R
author_facet Rajendrababu, Sharmila
Shroff, Sujani
Patil, Sangeeta Vivek
Uduman, Mohammed Sithiq
Vardhan, Ashok
Krishnadas, S R
author_sort Rajendrababu, Sharmila
collection PubMed
description PURPOSE: To evaluate the surgical outcomes of repeat trabeculectomy augmented with risk factor adjusted mitomycin C (MMC) exposure in eyes with previous failed trabeculectomy. METHODS: Case records of 38 eyes of 37 patients with previous failed filter who underwent repeat trabeculectomy with MMC were reviewed retrospectively. Main outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP) reduction, requirement of anti-glaucoma medications, postoperative complications, and surgical success (defined as IOP of ≤21 mmHg and >5 mmHg along with 20% reduction from preoperative IOP with or without adjuvant medications) at 1-year postoperatively. Statistical analysis was done using the STATA 14.1 (Texas, USA). RESULTS: Patient's mean age was 46.41 (±20.43) years and the mean preoperative IOP was 32.73 (±9.26) mmHg which reduced to 16.22 (±7.08) mmHg postoperatively at 12 months (P < 0.001). Mean number of anti-glaucoma medications reduced from 2.76 (±0.83) preoperatively to 1.89 (±0.95) postoperatively (P < 0.001). Surgical success was observed in 81.1% at 1 year (n = 30). Eyes that received MMC >3 min had a postoperative mean IOP of 12.50 (±3.23) mmHg compared to 23.08 (±7.19) mmHg with MMC <3 min (P < 0.001). Seven eyes (18.4%) developed postoperative complications, and all were seen in eyes that received MMC >3 min (P = 0.033). CONCLUSION: Repeat trabeculectomy with MMC, used in higher concentration and exposure time altered according to individual risk factor plays a crucial role in the success and hence it could be considered as a viable option before planning a tube surgery.
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spelling pubmed-63241212019-01-25 Surgical outcomes of repeat trabeculectomy augmented with high dose mitomycin C Rajendrababu, Sharmila Shroff, Sujani Patil, Sangeeta Vivek Uduman, Mohammed Sithiq Vardhan, Ashok Krishnadas, S R Indian J Ophthalmol Original Article PURPOSE: To evaluate the surgical outcomes of repeat trabeculectomy augmented with risk factor adjusted mitomycin C (MMC) exposure in eyes with previous failed trabeculectomy. METHODS: Case records of 38 eyes of 37 patients with previous failed filter who underwent repeat trabeculectomy with MMC were reviewed retrospectively. Main outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP) reduction, requirement of anti-glaucoma medications, postoperative complications, and surgical success (defined as IOP of ≤21 mmHg and >5 mmHg along with 20% reduction from preoperative IOP with or without adjuvant medications) at 1-year postoperatively. Statistical analysis was done using the STATA 14.1 (Texas, USA). RESULTS: Patient's mean age was 46.41 (±20.43) years and the mean preoperative IOP was 32.73 (±9.26) mmHg which reduced to 16.22 (±7.08) mmHg postoperatively at 12 months (P < 0.001). Mean number of anti-glaucoma medications reduced from 2.76 (±0.83) preoperatively to 1.89 (±0.95) postoperatively (P < 0.001). Surgical success was observed in 81.1% at 1 year (n = 30). Eyes that received MMC >3 min had a postoperative mean IOP of 12.50 (±3.23) mmHg compared to 23.08 (±7.19) mmHg with MMC <3 min (P < 0.001). Seven eyes (18.4%) developed postoperative complications, and all were seen in eyes that received MMC >3 min (P = 0.033). CONCLUSION: Repeat trabeculectomy with MMC, used in higher concentration and exposure time altered according to individual risk factor plays a crucial role in the success and hence it could be considered as a viable option before planning a tube surgery. Medknow Publications & Media Pvt Ltd 2019-01 /pmc/articles/PMC6324121/ /pubmed/30574901 http://dx.doi.org/10.4103/ijo.IJO_682_18 Text en Copyright: © 2018 Indian Journal of Ophthalmology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Rajendrababu, Sharmila
Shroff, Sujani
Patil, Sangeeta Vivek
Uduman, Mohammed Sithiq
Vardhan, Ashok
Krishnadas, S R
Surgical outcomes of repeat trabeculectomy augmented with high dose mitomycin C
title Surgical outcomes of repeat trabeculectomy augmented with high dose mitomycin C
title_full Surgical outcomes of repeat trabeculectomy augmented with high dose mitomycin C
title_fullStr Surgical outcomes of repeat trabeculectomy augmented with high dose mitomycin C
title_full_unstemmed Surgical outcomes of repeat trabeculectomy augmented with high dose mitomycin C
title_short Surgical outcomes of repeat trabeculectomy augmented with high dose mitomycin C
title_sort surgical outcomes of repeat trabeculectomy augmented with high dose mitomycin c
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324121/
https://www.ncbi.nlm.nih.gov/pubmed/30574901
http://dx.doi.org/10.4103/ijo.IJO_682_18
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