Comparison of the clinical efficacy and safety of deep sclerectomy with mitomycin-c and trabeculectomy surgerie

Comparison of the clinical efficacy and safety of deep sclerectomy with mitomycin-c and trabeculectomy surgerie

Aim: Comparison of clinical efficacy and safety of trabeculectomy and deep sclerectomy with mitomycin-C (MMC) surgeries.Material and Methods: 58 eyes of 58 patients with glaucoma who underwent trabeculectomy or deep sclerectomy with MMC were evaluated retrospectively. The success criterion was regarded as follows; patients having intraocular pressure (IOP) less than 21 mmHg was regarded as complete success; patients with IOP less than 21 mmHg with medication was regarded as partial success; and patients with IOP higher than 21 mmHg with medication was regarded as un-success.Results: There was no statistically significant difference in IOP lowering effects between the two surgeries. Considering the success of the groups; complete success was achieved in 32 patients (91.4%) and partial success in 3 patients (8.6%) in the trabeculectomy group. Complete success was achieved in 20 patients (86.9%) and partial success in 3 patients (13.1%) in the deep sclerectomy with MMC group. In the deep sclerectomy with MMC group, hypotonia was detected in 2 patients (8.7%). In the trabeculectomy group, 5 patients (14.3%) had hypotonia, 2 patients (5.7%) had shallow anterior chamber and 1 patient (2.85%) had choroidal detachment.Conclusion: When IOP lowering effects of deep sclerectomy with MMC and trabeculectomy operations were compared, it was found that there was no statistically significant difference between the two techniques. When complication rates were compared, less complication was found in deep sclerectomy operations. It can be concluded that deep sclerectomy is safer than trabeculectomy and as effective as it is.

___

  • 1. Blodi FC, Historical introduction: Development of our concept of glaucoma, Denny M, Taylor F, Section 10: Glaucoma, Basic and Clinical Science Course, San Francisco, Am Acad Ophthalmol 1999-2000:5-6.
  • 2. Bengisu Ü, Bölüm 9: Glokom, Göz Hastalıkları 4. Baskı, Ankara, Palme Yayıncılık, 1998;139-59.
  • 3. Cantor L, Berlin MS, Hodapp EA, Lee DA, Wilson MR, Wand M, Introduction and definitions, Denny M, Taylor F, Section 10: Glaucoma, Basic and Clinical Science Course, San Francisco, American Academy of Ophthalmology 1999-2000;7.
  • 4. Goldenfeld M, Krupin T, Ruderman MJ, et al. 5-FU in initial trabeculectomy.A prospective, randomized, multicenter study. Ophthalmology 1994;101:1024-9.
  • 5. Ophir A, Ticho U. A randomized study of trabeculectomy and subconjunctival administration of fluorouracil in primary glaucomas. Arch Ophthalmol 1992;110:1072-5.
  • 6. MB. Sherwood, CS. Migdal, RA. Hitchings. Initial treatment of glaucoma: Surgery or medications, Surv Ophthalmol 1993;37:293-99
  • 7. Jay JL, Allan D, The benefit of early trabeculectomy versus conventional management in primary open angle glaucoma relative to severity of disease. Eye (Lond) 1989;3:528-35.
  • 8. Jay JL, Murray SB, Early trabeculectomy versus conventional management in primary open angle glaucoma. Br J Ophthalmol 1988;72:881-9.
  • 9. Ambresin A, Shaarawy T, Mermoud A. Deep sclerectomy with collagen implant in one eye compared with trabeculectomy in the other eye of the same patient. J Glaucoma 2002;11:214-20.
  • 10. D’Ermo F, Bonomi L, Duro D, A critical analysis of the long-term results of trabeculectomy. Am J Ophthalmol 1979;88:829-35.
  • 11. Inaba Z. Long-term result of trabeculectomy in the Japanese: An analysis by life-table method. Jpn J Ophthalmol 1982;26:361-73.
  • 12. Jerdnal T, Lundström M. 330 trabeculectomies: a follow up study through 1/2 and 3 years. Acta Ophthalmol (Copenh) 1977;55:52-62.
  • 13. Yıldırım E, Bilge AH, İlker S. Improvement of visual field following trabeculectomy for open angle glaucoma. Eye (Lond) 1990;4:103-6.
  • 14. Popovic V, Sjöstrand J, Long-term following trabeculectomy: II. Visual field survival, Acta Ophthalmol (Copenh) 1991;69:305-9.
  • 15. Molteno AC, Bosma NJ, Kittelson JM, Otago glaucoma surgery outcome study long term result of trabeculectomy 1976-1995. Ophtalmology 1999;106:1742-50.
  • 16. Cheung JC, Wright MM, Murali S, et al. Intermediate-term outcome of variable dose mitomycin-C filtering surgery. Ophthalmology 1997;104:143-9.
  • 17. Goins K, Smith T, Kinker R, et al. Axial anterior chamber depth after trabeculectomy. Ophthalmologica 1990;2004:177-80.
  • 18. Peng SX, Zhou WB. The anterior chamber depth after trabeculectomy. Zhonghua Yan Ke Za Zhi 1992;28:214-6.
  • 19. Klink T, Lieb WE, Göbel W, Early and late findings with optical coherence tomography (OCT) in patients with postoperative hypotonia. Ophthalmologe 2000;97:353-8.
  • 20. Karasheva G, Goebel W, Klink T, et al. Changes in macular thickness and depth of anterior chamber in patients after filtration surgery. Graefes Arch Clin Exp Ophthalmol 2003;241:170-5.
  • 21. Al-Obeidan SA, Mousa A, Naseem A, et al. Efficacy and safety of non-penetrating deep sclerectomy surgery in Saudi patients with uncontrolled open angle glaucoma. Saudi Med J 2013;34:54-61.
  • 22. Suominen S, Harju M, Kurvinen L, et al. Deep sclerectomy in normal-tension glaucoma with and without mitomycin-c. Acta ophthalmologica 2014;927:701-6.
  • 23. Karakurt A, Sarıcaoğlu MS, Bilgin G. Psödoeksolyatif glokom ve katarakt birlikteliğinde fakoemülsifikasyonla kombine derin sklerektomi: etkinlik ve güvenirlik. Glokom-Katarakt/Journal of Glaucoma-Cataract 2015;10:3.
  • 24. Harju M, Suominen S, Allinen P, et al. Long-term results of deep sclerectomy in normal tension glaucoma. Acta ophthalmologica 2018;96:154-60.
  • 25. Ollikainen ML, Puustjärvi TJ, Rekonen PK, et al. Mitomycin C-augmented deep sclerectomy in primary open-angle glaucoma and exfoliation glaucoma: a three-year prospective study. Acta ophthalmologica 2011:89:548-55.
  • 26. Mercieca K, Shevade B, Anand N. Outcomes of combined phacoemulsification and deep sclerectomy: a 10-year UK single-centre study. Eye (Lond) 2015;29:1495-503.
  • 27. Özsoy A, Sarıcaoğlu MS, Çavuşoğlu M. The effect of deep sclerectomy on ocular blood flow: a 6-month clinical trial. Turk J Med Sci 2016;46:1773-8.
  • 28. Igor L, Benjamin P, Esther BO, et al. Central 10-degree visual field change following non-penetrating deep sclerectomy in severe and end-stage glaucoma: preliminary results. Graefe’s Arch Clin Exp Ophthalmol 2018;256:1489-98.
  • 29. Loriaut P, Nordmann JP, Laroche L, et al. Deep sclerectomy versus trabeculectomy in eyes with penetrating keratoplasty. Cornea 2015;34:375-80.
  • 30. Mercieca K, Steeples L, Anand N, et al. Deep sclerectomy for uveitic glaucoma: long-term outcomes. Eye (Lond) 2017;31:1008-19.
  • 31. Al Obeidan SA, Osman EA, Mousa A, et al. Long-term evaluation of efficacy and safety of deep sclerectomy in uveitic glaucoma. Ocul Immunol Inflamm 2015;23;82-9.
Annals of Medical Research-Cover
  • Yayın Aralığı: Aylık
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

The clinical outcomes of intravitreal dexamethasone implant as the first-line treatment in retinal vein occlusion related macular edema

Yücel KARAKURT

Videolaryngoscopy versus direct laryngoscopy in without muscle relaxation intubation conditions in tympanomastoidectomy: A randomized, prospective clinical study

Ökkeş Hakan MİNİKSAR, Yusuf Ziya ÇOLAK

Evaluation of the relationship between concha bullosa and nasal septum deviation with diameter of nasolacrimal duct

Ibrahim INAN, Mehmet SİRİK

Laparoscopic cholecystectomy under spinal anesthesia in high risk patients: A single center experience

Mehmet BAYRAK, Yasemin ALTINTAŞ

Evaluation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume in patients with lichen planus

Murat ÖZTÜRK, Derya UÇMAK, Isa AN

Usage length of sternum components and sternal angle through images obtained by computerized tomography image reconstruction in gender determination

Zulal ONER, Bunyamin SAHİN, Ibrahim KURTUL, Serkan ÖNER

Can clinical frailty scale be used routinely in patients aged 50 years and older in intensive care units?

Çiğdem SİZER, Hasan Nabi UNDAR, Filiz SEVEN, Faruk CİCEKCİ, İskender KARA

Comparison of routine laboratory tests in acute appendicitis and intussusception in childhood

Kubilay GÜRÜNLÜOĞLU, Aytaç TAŞCİ, Mehmet DEMİRCAN, Harika GÖZÜKARA BAG

A case of erythema ab igne induced by laptop computer

Murat ÖZTÜRK, Göktürk DERE

The clinical and histopathological effects of perineural dexmedetomidine and in combination with sodium bicarbonate in sciatic nerve block in rabbits after sevoflurane anesthesia: A placebo controlled, randomized experimental study

Ahmet Selim OZKAN, Sedat AKBAS, Resit SEVİMLİ, Saadet ALAN