Abstract
Purpose :
Recent variations in the way MMC is administered during surgery has been described but their efficacy and safety is not clearly known. This study retrospectively assessed the one-year results of MMC-supplemented trabeculectomies performed in a cohort of patients in which the MMC delivery technique was either from sub-tennon’s injection (STI) or STI plus impregnated sponges placed under the conjunctiva.
Methods :
A consecutive series of 115 MMC-supplemented trabeculectomy cases was retrospectively analyzed and the results were compared into two groups (STI or group 1 vs. STI + sponges or Group 2). All cases were followed-up at least over a one-year period. IOP reduction, surgical success, number of post-operative medications and side-effects were main analyzed outcomes.
Results :
In this retrospective comparative analysis, age, gender proportion, type of glaucoma, severity of disease, baseline IOP and number of preoperative medications were not significantly different between groups. In both groups IOP significantly decreased (P=0.001) when baseline IOP was compared against IOP at all time points (1 day, 1 week, 2 weeks, 1 month, 3 months, 6 months and one year. Mean IOP was significantly lower in group 2 at months 6 and 9 as compared to group 1 (14.6±3.9 mm Hg vs. 12.3±1.9 mm Hg, P=0.0002; 15.1±4.2 mm Hg vs. 12.0±2.3 mm Hg, P=0.0001; repeated measures ANOVA / Bonferroni correction). The overall success rate was greater in group 2 (93% vs. 84%, P=0.16, c2). Post-operative number of medications was not diffferent between groups. VA remained stable in both groups. Most common complications were hypotony, choroidal effusion and shallow AC with no significant differences between groups. AC reformation was required in two cases after needling in group 1 and one case of choroidal effusion drainage in group 2.
Conclusions :
The two methods used to supplement MMC in this study have comparable and aceptable levels of efficacy and safety. Group 2 (STI + sponges) seems to induce lower IOP values at some time points and a slightly more favorable overall success (no statistically difference achieved).
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.