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Sakari Suominen, Mika Harju, Leena Kurvinen, Eija T. Vesti; Deep Sclerectomy In Normal Tension Glaucoma With And Without Mitomycin-c. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2526.
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To compare the outcome of deep sclerectomy (DS) with and without Mitomycin-C (MMC) in normal tension glaucoma (NTG) patients.
We prospectively analysed the results of 37 eyes of 37 consecutive patients with NTG (age; median, range; 63 years, 48-79) who underwent DS with a collagen implant. Patients were randomized to the Mitomycin-C (MMC) and non-MMC groups; subconjunctival MMC (0.4 mg/ml for 3 minutes) was used intra-operatively in 15 of 37 eyes. Patients were followed for 12 months.
Intraocular pressure (IOP; median, range; 15.2 mmHg, 10.2 - 21.3) was significantly reduced after 12 months (11.3, 5-16, P<0.001).The median postoperative IOP was significantly lower in the MMC group (10.0mmHg, 5-13) compared to the non-MMC group (11.4 mmHg, 8-16, P=0.005). A 25% reduction in IOP without medication was achieved overall in 19/37 eyes (51%), in 10/15 eyes (67%) in MMC group and in 9/22 eyes (41%) in non-MMC group (P=0.13).After 12 months, 27 eyes (73%) were without glaucoma medication and goniopuncture had been performed in 7 eyes (47%) in the MMC group, compared to 16 eyes (73%) in the non-MMC group (P=0.13).Altogether, complications included loss of three or more snellen lines in visual acuity (4 patients), microperforation (1), re-suturation of conjunctiva (6) and dellen formation (2). No patient had shallow anterior chamber, choroideal ablation or late bleb leak.
Clinically and statistically significant IOP reduction was shown after deep sclerectomy in both groups. Intra-operative use of MMC results in lower post-operative IOP after one year. DS seems to be effective and safe in reducing IOP in patients with NTG.
Helsinki University, 486/E9/E06
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