A Placebo-controlled, Double-masked Evaluation of Mitomycin C in Combined Glaucoma and Cataract Procedures

Cohen, John; Greff, Linda J; Novack, Gary D.; Wind, Brian E.

doi:10.1016/s0161-6420(96)30405-3

Cited by 90 publications

(44 citation statements)

References 30 publications

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“…23 The use of augmenting antimetabolites may further increase the risk of bleb leak. 24,25 This study showed bleb leakage to be considerably higher in fornix-based as opposed to limbal-based procedures with 25.8% of all fornix-based procedures having a bleb leak whereas 11.5% of all limbal-based procedures had a bleb leak, an observation that is supported by previous literature. [1][2][3][4][5]26,27 Batterbury and Wishart 1 reported postoperative leaks in 4% of all limbalbased procedures, whereas a significantly greater incidence was found in their fornix-based group (56%).…”

Section: Discussionsupporting

confidence: 86%

Early bleb leak after trabeculectomy and prognosis for bleb failure

Alwitry

Rotchford

Patel

et al. 2008

Eye

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Aim To determine whether early bleb leak after MMC trabeculectomy affects intermediate intraocular pressure (IOP) outcome. Methods Retrospective case note review. All cases of MMC trabeculectomy with at least 1-year follow-up were included. Cases where a bleb leak occurred within the first month were identified. All cases without an early bleb leak formed the control group. Patient demographics and clinical factors were analysed to determine any factors predisposing to bleb leakage. IOPs were compared for 1 year postoperatively and final follow-up. Results A total of 119 trabeculectomies were included. Of these 27 (22.7%) had an early bleb leak. The remaining 92 cases formed the control group. Mean age of cases was 70.7 years. Mean follow-up time was 19.5 months. Mean time of detection of the bleb leak was 9 days (range 1-21 days). Four cases (14.8%) were managed by primary resuturing. Thirteen cases (48.1%) were managed conservatively with a bandage contact lens. Ten cases (37.0%) resolved with expectant management. There was no statistically significant difference between the two groups with regards to IOP measurement at any time point. Intervention rates were similar with regards to bleb massage, 5-fluorouracil injection, and needling revision. No factors were identified between the two groups that predisposed to bleb leaks occurring. Conclusion Our data suggest that early bleb leak is not a poor prognostic indicator for intermediate bleb survival and IOP control in patients undergoing MMC trabeculectomy. No additional bleb manipulations compared with the control group were required to achieve a satisfactory IOP outcome.

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Section: Discussionsupporting

confidence: 86%

Early bleb leak after trabeculectomy and prognosis for bleb failure

Alwitry

Rotchford

Patel

et al. 2008

Eye

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“…32,33 There is also evidence for a similar role of MMC in primary DS. [34][35][36][37][38][39] The decision to use MMC during individual surgical cases was difficult to pinpoint from our database.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of combined phacoemulsification and deep sclerectomy: a 10-year UK single-centre study

Mercieca

Shevade

Anand

2015

Eye

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Purpose To report the outcomes of combined phacoemulsification and -deep sclerectomy (phaco-DS) from a single UK centre over a 10-year period. Methods Retrospective analysis of phaco-DS data extracted from an ongoing glaucoma surgery database within Calderdale and Huddersfield NHS Trust. Two hundred and ninety-six eyes of 282 patients were included. Data included patient demographics, pre-and postoperative intraocular pressure (IOP), use of mitomycin C (MMC), spacer device implantation, and follow-up details including surgical success rates. IOP success criteria were: (A) IOP o19 mm Hg and/or 20% decrease from baseline and (B) IOP o16 mm Hg and/or 30% drop from baseline. Results Mean follow-up was 63.5 ± 35.3 months. MMC was applied in 145 eyes (49%). Kaplan-Meier success rates in all eyes for criteria A were 89.1% and 80% with glaucoma medications (qualified success) and 81.2% and 68.3% without medications (unqualified success) at 2 and 5 years, respectively. Qualified success for criteria B was 72.4 and 61.4% and unqualified rates were 67.2 and 55.2% for the same time periods. Repeatedmeasures ANOVA showed significantly lower IOP in the phaco-DS with MMC group up to 3 years postoperatively (P = 0.002). Cox's proportional hazards for criteria B, however, showed no significant effect of MMC application in the long term (P = 0.2). Increasing age and laser goniopuncture were positively associated with success, whereas the absence of spacer devices was negatively associated. At last follow-up, 20% of eyes were on glaucoma medications. Complication rates were low with hypotony rates of 0.68%. Conclusions This study confirms the longterm safety and efficacy of phaco-DS as a primary glaucoma procedure.

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“…To date, an effective drug that specifically prevents fibrosis is not available, with the exception of antiproliferative drugs, such as mitomycin C and 5-fluorouracil, which have been shown to improve the surgical outcomes of glaucoma filtration surgery. 59,60 Given the critical role of TGF-b2 in the pathogenesis of fibrosis, researchers have devoted substantial efforts to target TGF-b2 signaling with different molecules, including antibodies, siRNA, and small molecule inhibi- tors. [61][62][63] Notably, monoclonal antibodies have been attracting increasing attention because of their specificity and successful clinical applications in other diseases.…”

Section: Discussionmentioning

confidence: 99%

YAP/TAZ Are Essential for TGF-β2–Mediated Conjunctival Fibrosis

Futakuchi

Inoue

Wei

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To investigate the roles of Yes-associated protein (YAP)/transcriptional co-activator with PDZ-binding motif (TAZ), the major effector molecules of the Hippo pathway, in TGFb2-mediated conjunctival fibrosis.METHODS. Primary human conjunctival fibroblasts were treated with TGF-b2. The expression of YAP/TAZ was examined by Western blot analyses and immunocytochemistry. The expression of fibrotic proteins and genes were evaluated by Western blot analyses and quantitative real-time PCR, respectively. The effects of YAP/TAZ on fibrotic changes were examined by knockdown experiments and the YAP/TAZ inhibitor, verteporfin.RESULTS. TGF-b2 stabilized YAP/TAZ and subsequently activated Smad2/3, which led to the transcription of fibrotic genes in human primary conjunctival fibroblasts. These fibrotic genes were differently regulated by YAP/TAZ. Notably, a-smooth muscle actin, fibronectin, collagen I, and collagen IV were primarily regulated by YAP. In contrast, CCN family proteins (CTGF and CYR61) depended on both YAP and TAZ. Mechanistically, YAP/TAZ were located in close proximity to Smad2/3, and in particular, YAP was required for TGF-b2-mediated phosphorylation and the nuclear translocation of Smad2/3. Furthermore, a YAP/TAZ inhibitor markedly suppressed TGF-b2-mediated fibrotic changes in conjunctival fibroblasts.CONCLUSIONS. YAP/TAZ acted as a molecular hub of TGF-b2 signaling in a cellular model of conjunctival fibrosis. Moreover, verteporfin, a YAP/TAZ inhibitor exerted potent antifibrosis effects by suppressing TGF-b2-YAP/TAZ-Smad signaling. Our study highlights YAP/TAZ as essential regulators of conjunctival fibrosis and shows that inhibition of YAP/TAZ might potentially improve the outcomes of glaucoma filtration surgery.

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A Placebo-controlled, Double-masked Evaluation of Mitomycin C in Combined Glaucoma and Cataract Procedures

Cited by 90 publications

References 30 publications

Early bleb leak after trabeculectomy and prognosis for bleb failure

Early bleb leak after trabeculectomy and prognosis for bleb failure

Outcomes of combined phacoemulsification and deep sclerectomy: a 10-year UK single-centre study

YAP/TAZ Are Essential for TGF-β2–Mediated Conjunctival Fibrosis

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