Non‐penetrating glaucoma surgery augmented with mitomycin C or 5‐fluorouracil in eyes at high risk of failure of filtration surgery: long‐term results

Choudhary, Anshoo; Wishart, P K

doi:10.1111/j.1442-9071.2007.01483.x

Cited by 21 publications

(15 citation statements)

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“…Other studies evaluating the use of adjunctive MMC with other nonfiltering glaucoma surgeries support the findings of the study reported here. 17 This case series adds to our understanding of factors, which may help to improve the success of canaloplasty. The use of MMC apparently contributed to further reductions in IOP and medication use, conceivably slowing the inflammatory response in the scleral lake and TDW.…”

Section: Discussionmentioning

confidence: 92%

“…16 Intraoperative MMC is thought to prevent collapse of the intrascleral lake and increase the success rate of viscocanalostomy particularly in complicated eyes and without a substantial increase in the risk of hypotony and endophthalmitis. 17 As IOP control in canaloplasty may also be dependent on the formation of a scleral lake in addition to viscodilation and trabecular meshwork tensioning, low-dose intraoperative MMC could have a beneficial effect on canaloplasty, especially in high-risk patients. In this retrospective study, the use of low-dose MMC adjuvant therapy in conjunction with canaloplasty was investigated in a preliminary, noncomparative case series.…”

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confidence: 99%

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Canaloplasty With Intraoperative Low Dosage Mitomycin C

Barnebey¹

2013

Journal of Glaucoma

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Section: Discussionmentioning

confidence: 92%

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confidence: 99%

Canaloplasty With Intraoperative Low Dosage Mitomycin C

Barnebey¹

2013

Journal of Glaucoma

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“…Non-penetrating glaucoma surgery (NPGS) has been shown to provide comparable long-term qualified success rates to trabeculectomy, with reduced post-operative complications [9–11] but there is limited information on its success in patients with advanced glaucoma.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of viscocanalostomy and phaco-viscocanalostomy in patients with advanced glaucoma

Tsagkataki

Bampouras

Choudhary

2018

Graefes Arch Clin Exp Ophthalmol

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PurposeTo determine the medium-term outcomes for patients with advanced glaucoma undergoing viscocanalostomy.MethodsAll patients with advanced glaucoma (mean deviation (MD) − 12.00 dB or above) and patients with poor visual acuity secondary to advanced glaucoma which precluded formal visual field assessment undergoing viscocanalostomy (VC) and phaco-viscocanalostomy between 2010 and 2014 under the care of a single surgical team were included. Intraocular pressure (IOP), visual acuity (VA) and visual field outcomes were assessed from data prospectively collected into a surgical outcome database. Success was defined at two IOP cut-off points: IOP ≤ 21 and ≤ 16 mmHg with (qualified) or without (complete) medications.ResultsOne hundred thirty-five patients were included. Mean IOP changed from 23.6 ± 6.4 mmHg pre-operatively to 15.3, 15.8 and 14.8 mmHg at 1, 2 and 3 years, a change of 35, 33.5 and 39% respectively. Qualified success for an IOP ≤ 21 mmHg was achieved in 95.66, 90.6 and 80% and complete success in 52.5, 48.6 and 30.6% at year 1, 2 and 3. Qualified success for an IOP ≤ 16 mmHg was achieved in 66.6, 66.05 and 60% and complete success in 44.8, 37.6 and 30.6% at year 1, 2 and 3. The cumulative probability for achieving an IOP ≤ 21 mmHg with or without drops was 86.1, 81.4 and 81.4% at 12, 24 and 36 months. Eleven patients (8.1%) failed to achieve adequate IOP control and needed further surgical intervention. Eleven (8.1%) patients needed an intervention (Yag goniopuncture) following VC. Four patients (2.9%) had some post-operative complications, which resolved within 2 weeks following surgery. Nine patients (6.7%) lost more than 2 Snellen lines. There was no significant change in the MD across time points.ConclusionViscocanalostomy and viscocanalostomy combined with phacoemulsification is a safe and effective method of controlling IOP in the medium term in patients with advanced glaucoma.

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“…25 DS with MMC has been reported to be a safe and effective procedure for eyes with failed trabeculectomy. 26,27 There has been a lack of consensus among glaucoma surgeons as to the best surgical option in eyes at a high-risk-to-failure, such as previous intraocular surgery. The Tube versus Trabeculectomy (TVT) trial was designed to prospectively assess trabeculectomy and Bearveldt tube implant (BGI) surgery, both augmented with MMC, in eyes with previous cataract surgery and/or failed trabeculectomy.…”

Section: Introductionmentioning

confidence: 99%

Deep sclerectomy with mitomycin C in eyes with failed glaucoma surgery and pseudophakia

Anand

Wechsler²

2011

Eye

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Purpose To report outcomes of deep sclerectomy (DS) with intraoperative mitomycin C (MMC) application in eyes with previous failed glaucoma surgery (GS) and/or cataract extraction (CE). Patients and methods Single-surgeon case series of 82 eyes of 82 patients undergoing DS with MMC. The patients had previous CE with IOL and/or conjunctival GS and treated intraocular pressure (IOP) 418 mm Hg. MMC (0.2 mg/ml) was applied for 2-3 min before scleral flap dissection. Complete success was defined as IOP between 6 and 21 mm Hg or a reduction of 20% from baseline without medications. Reoperation for glaucoma or related complications, or loss of light perception vision was considered as failure. Results Mean follow-up was 57.7±22.4 months with 78% of patients completing the 3-year follow-up. Mean IOP decreased from 24.0 mm Hg (22.3-25.6, 95% confidence intervals) to 13.4 mm Hg (12.0-14.2) at 3 years after surgery (Po0.001). There was a significant decrease in the number of glaucoma medications from 2.0±1 preoperatively, to 0.3±0.7, 3 years after surgery. Kaplan-Meier cumulative success rates were 85.6% at 1 year, 80.0% at 2 years, and 76% at 3 years. At 3 years, IOP was maintained o19 and 15 mm Hg in 83 and 70% of eyes, respectively. Fourteen eyes (17.1%) had complications. Delayed hypotony (IOP o6 mm Hg) was the commonest complication in five eyes (6.1%). Conclusion DS with MMC appears to be a safe and effective surgical procedure for eyes with previous intraocular surgery.

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Non‐penetrating glaucoma surgery augmented with mitomycin C or 5‐fluorouracil in eyes at high risk of failure of filtration surgery: long‐term results

Abstract: NPGS augmented with small-volume MMC/5FU provides good long-term IOP control in eyes at high risk of failure with a lower incidence of complications compared with augmented trabeculectomy and eliminates the need for postoperative bleb or suture manipulation.

Cited by 21 publications

References 45 publications

Canaloplasty With Intraoperative Low Dosage Mitomycin C

Canaloplasty With Intraoperative Low Dosage Mitomycin C

Outcomes of viscocanalostomy and phaco-viscocanalostomy in patients with advanced glaucoma

Deep sclerectomy with mitomycin C in eyes with failed glaucoma surgery and pseudophakia

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