Trabeculotomy Augmented by Postoperative Topical Medications vs. Trabeculectomy Augmented by Mitomycin C

Background/Aim: To evaluate the efficacy of trabeculectomy with mitomycin C (MMC) for lowering intraocular pressure (IOP) in patients with open angle glaucoma (OAG) secondary to emulsified silicone oil (SO) after pars plana vitrectomy. Methods: A single-center, prospective study was conducted, from December 2014 to December 2019, on 56 consecutive patients with an uncontrolled elevation of IOP after SO removal. The primary end-point was the IOP at the three-years follow-up visit. Complete surgical success was defined as an IOP ranging from 7 mmHg to 18 mmHg without glaucoma medication. Qualified success was defined as IOP ? 21 mmHg with one or two topical medications. Results: Fifty-six patients with mean (standard deviation) age of 56.6 (13.1) years had a mean baseline IOP of 42.3 (39.3 to 45.3) mmHg, which reduced to 18.6 (17.9 to 19.3) mmHg at 3 years after surgery (P < 0.0001). 17 (30.4%) eyes were classified as complete success, 21 (37,5%) as qualified success, and 18 (32.1%) as failure. In all treated patients, the number of antiglaucoma medications was significantly reduced from 2.85 (0.77) to 1.63 (0.62), p<0.0001. Conclusion: Trabeculectomy with MMC may be an option for lowering IOP in patients with OAG secondary to emulsified SO which was not controlled with maximum antiglaucomatous medical treatment.

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Same-Site Deep Sclerectomy Re-Operation with Subconjunctival and Subscleral Collagen Matrix (Ologen™) and Minimal use of Mitomycin C

The Open Ophthalmology Journal ◽

10.2174/1874364101913010043 ◽

2019 ◽

Vol 13 (1) ◽

pp. 43-50

Author(s):

Pablo Díaz-Aljaro ◽

Jordi Loscos-Arenas ◽

Pau Romera-Romero ◽

Nevena Romanic-Bubalo ◽

Stefano Grixolli-Mazzon ◽

...

Keyword(s):

Mitomycin C ◽

Collagen Matrix ◽

Final Visit ◽

Deep Sclerectomy ◽

Prospective Evaluation ◽

Safety And Efficacy ◽

Surgical Success ◽

Late Failure ◽

Second Surgery ◽

Topical Medications

Purpose:This study aimed to evaluate the safety and efficacy of same-site Deep Sclerectomy (DS) re-operation with subconjunctival and subscleral collagen matrix (Ologen™) and minimal use of mitomycin C in cases of late failure blebs.Methods:A prospective evaluation of consecutive patients on which same-site DS was performed with subconjunctival and subscleral collagen matrix (Ologen™) and minimal use of mitomycin C; all performed at a single university institution. Intraocular pressure (IOP), number of glaucoma medications, postoperative interventions, postoperative complications and surgical success were registered at 24 hours, 1, 6 and 12 months after the surgery.Results:Twenty-five eyes of 25 patients were included in this study. Time from first DS was 55.08 ± 28.16 months. Mean preoperative IOP was 20.88 ± 6.06 mmHg and it was reduced to 16.64 ± 4.02 mmHg, at 12 months after re-operation (p 0,007). At this final visit, requirements for topical medications dropped from a mean of 2.2 ± 1.0 to 0.72 ± 1.0 per patient and no medications were required in 60% of patients. Success was 36 % in criteria A (IOP ≤15mmHg), 72% in criteria B (IOP ≤18 mmHg) and 80 % in criteria C (IOP ≤15 mmHg), 12 months after the second surgery.Conclusion:The same-site DS re-operation with subconjunctival and subscleral collagen matrix (Ologen®) and minimal use of mitomycin C is a safe and adequate technique for the reduction of IOP, especially when targeted IOP is not lower than 15mmHg.

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Utility of Collagen Matrix Insertion during Ahmed Valve Implantation with Adjunctive Mitomycin-C: Outcomes at One-year

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2021.62.10.1388 ◽

2021 ◽

Vol 62 (10) ◽

pp. 1388-1396

Author(s):

Yong Hyun Kim ◽

Ko Eun Kim ◽

Chungwoon Kim ◽

Jae Hong Ahn

Keyword(s):

Mitomycin C ◽

Collagen Matrix ◽

Tube Placement ◽

Success Rates ◽

Implant Surgery ◽

Ahmed Valve ◽

Surgical Failure ◽

One Year ◽

Valve Implantation ◽

Topical Medications

Purpose: To compare the surgical outcomes of adjunctive mitomycin-C (MMC) Ahmed valve implantation with and without collagen matrix insertion.Methods: We retrospectively reviewed 108 eyes of 108 patients who underwent Ahmed valve implant surgery with adjunctive MMC. Collagen matrix insertion/Ahmed valve implant surgery (CM-AGV) was performed on 55 eyes, while conventional Ahmed valve implant surgery (AGV) was performed on 53 eyes. We defined surgical failure as an intraocular pressure (IOP) > 18 mmHg or <5 mmHg on two or more consecutive visits, regardless of medication status.Results: After surgery, the IOP and number of topical medications required fell significantly (compared with the preoperative period) in both groups (both p < 0.001); these findings did not significantly differ between groups. The cumulative surgical success rates at 1 year did not significantly differ between groups (78.2% vs. 79.2%, p = 0.54). The only risk factor significantly associated with surgical failure was a postoperative hypertensive phase. Anterior chamber (compared with sulcus) tube placement was significantly associated with visual acuity loss at 1 year postoperatively, but this did not significantly differ between groups.Conclusions: At the 1-year follow-up after Ahmed implant surgery with adjunctive MMC, the success rates of surgery with and without collagen matrix insertion were similar.

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