Title of article
Comparison of Surgical Outcomes of Sponge Application versus Subconjunctival Injection of Mitomycin-C during Combined Phacoemulsification and Trabeculectomy Surgery in Asian Eyes
Author/Authors
Chiew, Wenqi Yong Loo Lin School of Medicine - National University of Singapore, Singapore , Guo, Xiner Yong Loo Lin School of Medicine - National University of Singapore, Singapore , Hou Ang, Bryan Chin Department of Ophthalmology - National Healthcare Group Eye Institute - Tan Tock Seng Hospital, Singapore - Department of Ophthalmology - Woodlands Health Campus, Singapore , Hoon Lim, Angela Pek Department of Ophthalmology - National Healthcare Group Eye Institute - Tan Tock Seng Hospital, Singapore , Wei Leon Yip, Leonard Department of Ophthalmology - National Healthcare Group Eye Institute - Tan Tock Seng Hospital, Singapore
Pages
7
From page
253
To page
259
Abstract
Purpose: To compare the outcomes of combined phacoemulsification–trabeculectomy surgery with intraoperative sponge‑applied versus
subconjunctival injection of mitomycin‑C (MMC) in Asian eyes.
Methods: This was a retrospective review of 95 eyes that consecutively underwent combined phacoemulsification–trabeculectomy surgery
in a tertiary eye center in Singapore from January 2013 to June 2014. Data collected included intraocular pressure (IOP), best corrected visual
acuity, and number of glaucoma medications. Outcome measures included postoperative IOP and complications at various timepoints up to
12 months after surgery.
Results: Twenty eyes (21.1%) received 0.2 mg/ml subconjunctival MMC injection (“Group 1”) and 75 (78.9%) received 0.4 mg/ml
sponge‑applied MMC (“Group 2”). There was no difference between groups in demographics, IOP, and number of glaucoma medications
preoperatively. There was a reduction in IOP at postoperative month (POM) 1, 6, and 12 in both the groups (POM12: Group 1, −2.8 ± 5.36 mmHg,
P < 0.001; Group 2, −5.8 ± 6.29 mmHg, P = 0.054). At POM1, Group 2 showed a trend toward greater IOP reduction (−5.89 ± 7.67 mmHg
vs. −1.55 ± 5.68 mmHg, P = 0.061). However, at both POM6 and POM12, there was no statistically significant difference in IOP reduction
between the two groups. At POM12, complete success, defined as achieving an IOP of between 6 and 15 mmHg without the use of antiglaucoma
medications, was achieved in 11 (55%) eyes in Group 1 and 48 (64%) in Group 2 (P = 0.9). There was a lower rate of postoperative hypotony
in the Group 1 (0%) compared to Group 2 (8%) (P = 0.34).
Conclusion: Combined phacoemulsification–trabeculectomy with subconjunctival MMC injection has comparable outcomes to that with
sponge‑applied MMC, with a similar reduction in IOP at 1, 6, and 12 months postoperatively and a lower postoperative complication rate.
Keywords
Asian , Glaucoma , Mitomycin‑C , Trabeculectomy
Journal title
Journal of Current Ophthalmology
Serial Year
2021
Record number
2717108
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