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MS Juzych, EY Yoon, DH Shin, C Kim, A Obertynski; Influence of Mitomycin C on Refractive Error and Astigmatism Following 5x6 mm PMMA Intraocular Lens Versus Foldable Silicone or Acrylic Intraocular Lens Implantation During the Primary Glaucoma Triple Procedure . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3374.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Mitomycin C (MMC) has been used as an adjunct during the primary glaucoma triple procedure (PGTP) but its effect on refractive error (RE) and astigmatism has not been studied. This study was conducted to compare RE and astigmatism between 5x6 mm PMMA IOL and foldable silicone or acrylic IOL implantation in PGTP with and without MMC. Methods: 122 eyes, of 122 POAG patients, that underwent PGTP with and without MMC and without postoperative suture release were used. 41 eyes had no MMC: 34 had a PMMA IOL and 7 had a foldable acrylic or silicone IOL. 81 eyes had MMC: 46 had a PMMA IOL and 35 had a foldable IOL. Patients were refracted at 3, 6, and 12 months postoperatively. To calculate the amount of RE, the spherical equivalent was used (sphere + 1/2 cylinder). To compare astigmatism, cylinder was used. Results: In the no MMC eyes, there was no significant difference in RE and astigmatism at the 3, 6, and 12 month intervals between the PMMA and the foldable IOL groups. Both the no MMC PMMA and foldable IOL groups showed predominately with-the rule (WTR) changes by 12 month interval. In the MMC group, there was a significant difference in RE at the 3, 6, and 12 month intervals between the PMMA and the foldable IOL groups (P=.001, P=.006, and P=.014, respectively). The foldable IOL group had decreased RE at all three time intervals while the PMMA IOL group showed an increase in RE. A significant difference in astigmatism (P=.037) was observed only at the 12 month interval at which the foldable IOL group had a lower amount of astigmatism than the PMMA group. The MMC PMMA IOL group showed predominately WTR changes at the 3, 6, and 12 month intervals. The MMC foldable IOL group showed predominately against-the rule (ATR) changes at the 3, 6, and 12 month intervals. Conclusion: Using MMC as an adjunct during PGTP significantly decreased the amount of postoperative RE and astigmatism, and ATR change in astigmatic axis in the foldable IOL group as compared to the PMMA IOL group, while there was no significant difference in postoperative RE, and astigmatism astigmatic axis between the two groups without adjunctive MMC use.
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