BACKGROUND AND OBJECTIVE
To determine
whether adjunctive use of mitomycin C (MMC)
would increase the success rate of primary nonpenetrating
deep sclerectomy with collagen implant.
PATIENTS AND METHODS
Twenty-six patients
(26 eyes) with primary open-angle glaucoma uncontrolled
with maximally tolerated medical therapy were
randomly assigned to undergo nonpenetrating deep
sclerectomy and collagen implant, either with (13 eyes)
or without (13 eyes) 0.3 mg/mL of adjunctive MMC
for 3 minutes. Intraocular pressure (IOP), number of
glaucoma medications, and visual acuity were assessed
before and 12 and 24 months after surgery.
RESULTS
The mean age of the study patients
was similar in both groups (MMC = 68.1 ± 8 years,
control = 65.8 ± 6.8 years). At the 12- and 24-month
follow-up visits, the mean IOP with or without medications
was lower in the MMC group than in the
control group (15.6 ± 3.5 vs 17.2 ± 3.9 mm Hg at 12
months and 15.8 ± 5.6 vs 17.8 ± 2.8 mm Hg at 24
months, respectively). The IOP with or without medications
significantly decreased after surgery in both
groups (P < .05). Twelve months after surgery, the
IOP decreased by 48% in the MMC group and by
35% in the control group. At the end of follow-up
(24 months), the IOP decreased by 48% in the MMC
group and by 32% in the control group (P = .01). The
mean number of glaucoma medications decreased
after surgery, there was no significant difference in
complications (hyphema and suprachoroidal hemorrhage),
and visual acuity was unchanged throughout
the study in both groups.
CONCLUSION
The use of MMC in nonpenetrating
deep sclerectomy with collagen implant is safe
and improves surgical results.
[Ophthalmic Surg Lasers Imaging 2004;35:6-12.]
AUTHORS
From the Department of Ophthalmology (MN), Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Epidemiology Cancer Center (SS), Gertner Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel; Eye Clinic (SA), Moscow, Russia; and the Department of Ophthalmology (OG), Carmel Medical Center, Haifa, Israel.
Accepted for publication October 23, 2003.
The authors thank Esther Eshkol for editorial assistance.
Address reprint requests to Orna Geyer, MD, Head, Department of
Ophthalmology, Carmel Medical Center, 7 Michal Street, Haifa, Israel.
