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Glaucoma Surgery with Soaked Sponges with Mitomycin C vs Sub-Tenon Injection: Short-term Outcomes

AIM: The aim of this study is to compare the outcomes, success rates, complications, and number of interventions of the trabeculectomy surgery with mitomycin C (MMC) in two different techniques: conventional soaked sponges and sub-Tenon injection. MATERIALS AND METHODS: An observational retrospectiv...

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Autores principales: Guimarães, Maria EV, de Pádua Soares Bezerra, Bernardo, de Miranda Cordeiro, Frederico, Carvalho, Christiano HS, Danif, Daniella N, Prata, Tiago S, Dorairaj, Syril K, Kanadani, Fábio N
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Jaypee Brothers Medical Publishers 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6743312/
https://www.ncbi.nlm.nih.gov/pubmed/31564793
http://dx.doi.org/10.5005/jp-journals-10078-1254
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author Guimarães, Maria EV
de Pádua Soares Bezerra, Bernardo
de Miranda Cordeiro, Frederico
Carvalho, Christiano HS
Danif, Daniella N
Prata, Tiago S
Dorairaj, Syril K
Kanadani, Fábio N
author_facet Guimarães, Maria EV
de Pádua Soares Bezerra, Bernardo
de Miranda Cordeiro, Frederico
Carvalho, Christiano HS
Danif, Daniella N
Prata, Tiago S
Dorairaj, Syril K
Kanadani, Fábio N
author_sort Guimarães, Maria EV
collection PubMed
description AIM: The aim of this study is to compare the outcomes, success rates, complications, and number of interventions of the trabeculectomy surgery with mitomycin C (MMC) in two different techniques: conventional soaked sponges and sub-Tenon injection. MATERIALS AND METHODS: An observational retrospective study was performed with 79 eyes of 64 participants who underwent a glaucoma surgery with MMC. The conventional sponge soaked with MMC 0.03% for 3 minutes over the scleral flap (group I) and the subtenon injection of 0.1 mL of MMC 0.03% (group II) techniques were used to deliver the MMC. The data collected were patient demographics, preoperative intraocular pressure (IOP), central corneal thickness (CCT), number of pre- and postoperative ocular hypotensive drugs, postoperative complications, number of interventions, and need of further glaucoma surgery. RESULTS: Seventy-nine eyes were divided into two: 39 eyes (49.37%) in group I and 40 eyes (50.63%) in group II. Trabeculectomy was performed in 53.17% and phacotrabeculectomy in 46.83%. The IOP decreased from 18.0 ± 11.0 mm Hg at the baseline to 10.0 ± 3.0 mm Hg at the last visit in group I and, in group II, from 16.0 ± 10.0–13.0 ± 6.0 mm Hg (median ± ID), p < 0.001. There were no significant differences between the groups regarding demographics, median follow-up, IOP in baseline, CCT, drugs reduction, success criteria adopted, postsurgical interventions, surgical complications, and need for new procedures (p > 0.05). CONCLUSION: Sub-Tenon injection of MMC is a safe and as effective as the conventional soaked sponge method in trabeculectomies. This method reduces surgical time and sponge-related risks with equivalent surgical efficacy. CLINICAL SIGNIFICANCE: As trabeculectomy is still the most common surgical procedure to reduce IOP and scar formation is one of the main causes of surgical failure, it is important to develop surgical techniques to improve its outcomes. HOW TO CITE THIS ARTICLE: Guimarães MEV, de Pádua Soares Bezerra B, et al. Glaucoma Surgery with Soaked Sponges with Mitomycin C vs Sub-Tenon Injection: Short-term Outcomes. J Curr Glaucoma Pract 2019;13(2):50–54.
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spelling pubmed-67433122019-09-27 Glaucoma Surgery with Soaked Sponges with Mitomycin C vs Sub-Tenon Injection: Short-term Outcomes Guimarães, Maria EV de Pádua Soares Bezerra, Bernardo de Miranda Cordeiro, Frederico Carvalho, Christiano HS Danif, Daniella N Prata, Tiago S Dorairaj, Syril K Kanadani, Fábio N J Curr Glaucoma Pract Original Article AIM: The aim of this study is to compare the outcomes, success rates, complications, and number of interventions of the trabeculectomy surgery with mitomycin C (MMC) in two different techniques: conventional soaked sponges and sub-Tenon injection. MATERIALS AND METHODS: An observational retrospective study was performed with 79 eyes of 64 participants who underwent a glaucoma surgery with MMC. The conventional sponge soaked with MMC 0.03% for 3 minutes over the scleral flap (group I) and the subtenon injection of 0.1 mL of MMC 0.03% (group II) techniques were used to deliver the MMC. The data collected were patient demographics, preoperative intraocular pressure (IOP), central corneal thickness (CCT), number of pre- and postoperative ocular hypotensive drugs, postoperative complications, number of interventions, and need of further glaucoma surgery. RESULTS: Seventy-nine eyes were divided into two: 39 eyes (49.37%) in group I and 40 eyes (50.63%) in group II. Trabeculectomy was performed in 53.17% and phacotrabeculectomy in 46.83%. The IOP decreased from 18.0 ± 11.0 mm Hg at the baseline to 10.0 ± 3.0 mm Hg at the last visit in group I and, in group II, from 16.0 ± 10.0–13.0 ± 6.0 mm Hg (median ± ID), p < 0.001. There were no significant differences between the groups regarding demographics, median follow-up, IOP in baseline, CCT, drugs reduction, success criteria adopted, postsurgical interventions, surgical complications, and need for new procedures (p > 0.05). CONCLUSION: Sub-Tenon injection of MMC is a safe and as effective as the conventional soaked sponge method in trabeculectomies. This method reduces surgical time and sponge-related risks with equivalent surgical efficacy. CLINICAL SIGNIFICANCE: As trabeculectomy is still the most common surgical procedure to reduce IOP and scar formation is one of the main causes of surgical failure, it is important to develop surgical techniques to improve its outcomes. HOW TO CITE THIS ARTICLE: Guimarães MEV, de Pádua Soares Bezerra B, et al. Glaucoma Surgery with Soaked Sponges with Mitomycin C vs Sub-Tenon Injection: Short-term Outcomes. J Curr Glaucoma Pract 2019;13(2):50–54. Jaypee Brothers Medical Publishers 2019 /pmc/articles/PMC6743312/ /pubmed/31564793 http://dx.doi.org/10.5005/jp-journals-10078-1254 Text en Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd. © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Article
Guimarães, Maria EV
de Pádua Soares Bezerra, Bernardo
de Miranda Cordeiro, Frederico
Carvalho, Christiano HS
Danif, Daniella N
Prata, Tiago S
Dorairaj, Syril K
Kanadani, Fábio N
Glaucoma Surgery with Soaked Sponges with Mitomycin C vs Sub-Tenon Injection: Short-term Outcomes
title Glaucoma Surgery with Soaked Sponges with Mitomycin C vs Sub-Tenon Injection: Short-term Outcomes
title_full Glaucoma Surgery with Soaked Sponges with Mitomycin C vs Sub-Tenon Injection: Short-term Outcomes
title_fullStr Glaucoma Surgery with Soaked Sponges with Mitomycin C vs Sub-Tenon Injection: Short-term Outcomes
title_full_unstemmed Glaucoma Surgery with Soaked Sponges with Mitomycin C vs Sub-Tenon Injection: Short-term Outcomes
title_short Glaucoma Surgery with Soaked Sponges with Mitomycin C vs Sub-Tenon Injection: Short-term Outcomes
title_sort glaucoma surgery with soaked sponges with mitomycin c vs sub-tenon injection: short-term outcomes
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6743312/
https://www.ncbi.nlm.nih.gov/pubmed/31564793
http://dx.doi.org/10.5005/jp-journals-10078-1254
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