June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Surgical Outcomes of Augmented MMC Trabeculectomy After Failed Seton Surgery
Author Affiliations & Notes
  • Jose Paczka
    Oftalmologia, University of Guadalajara, Guadalajara, Mexico
    Glaucoma, Global Glaucoma Institute, Guadalajara, Mexico
  • Luz Giorgi-Sandoval
    Oftalmologia, Asistencia e Investigacion en Glaucoma, A.C., Guadalajara, Mexico
    Glaucoma, Global Glaucoma Institute, Guadalajara, Mexico
  • Miriam Ramos-Hernandez
    Oftalmologia, University of Guadalajara, Guadalajara, Mexico
  • Jesus Jimenez-Roman
    Oftalmologia, Asistencia e Investigacion en Glaucoma, A.C., Guadalajara, Mexico
    Glaucoma, Global Glaucoma Institute, Guadalajara, Mexico
  • Arie Merikansky
    Oftalmologia, Asistencia e Investigacion en Glaucoma, A.C., Guadalajara, Mexico
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4482. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Jose Paczka, Luz Giorgi-Sandoval, Miriam Ramos-Hernandez, Jesus Jimenez-Roman, Arie Merikansky; Surgical Outcomes of Augmented MMC Trabeculectomy After Failed Seton Surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4482.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose: To determine surgical rates in a consecutive series of cases of glaucoma treated with secondary trabeculectomy (supplemented with mitomycin C - MMC) in a setting of Ahmed glaucoma valve (AGV) failure.

Methods: In this retrospective non-comparative analysis, 24 consecutive cases affected by a mixture of glaucomas which failed after being surgically treated with AGV were assessed. In all cases, MMC (0.5 mg / 5 minutes of trans-operative subconjunctival exposure) supplemented the action of a “safe” trabeculectomy as a mean to control pressure. Using standard definition of surgical success / failure, Kaplan-Meier survival analysis was used to estimate surgical outcomes in cases which were followed up for at least 12 months.

Results: Medical chart information derived from twenty four eyes of 20 patients (13 females, 7 males; mean age: 57.6 ± 11.3 years) was included in the analysis. All eyes had received an AGV as a primary procedure to treat different types of glaucoma. A diversity of reasons was evaluated by the treating surgeon to decide for a new glaucoma intervention. Cumulative causes of AGV failure included tube / plate exposure (n = 11), refractory hypertensive phase (n = 7), endothelium / lens tube contact (n = 4), miscellaneous (n = 8). Pre-trabeculectomy mean IOP was 16.8 ± 6.9 mm Hg. Overall success rate with secondary trabeculectomy was 96% and 92%, at the 6-month and 12-month post-operative moments, respectively. Mean post-operative IOP was 11.4 ± 2.4 mm Hg (P = 0.001) and 13.5 ± 3.3 mm Hg (P = 0.001) after 6 and 12 months after trabeculectomy, respectively. Cumulative complication rate was 12%.

Conclusions: Our findings demonstrated that secondary trabeculectomy supplemented with MMC is a very good surgical alternative to treat diverse types of AGV failure when this procedure was used as a primary operation.

Keywords: 462 clinical (human) or epidemiologic studies: outcomes/complications • 765 wound healing • 568 intraocular pressure  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×