Two-Year Outcome of Repeat Trabeculectomy with Mitomycin C in Primary Open-Angle and PEX Glaucoma

Abstract

Repeat trabeculectomy with MMC is successful at lowering IOP in POAG and PEXG and permits a significant and safe reduction of antiglaucomatous medication for at least 2 years after surgery.

Surgical outcomes of repeat trabeculectomy augmented with high dose mitomycin C

“…Total success in our study group was 81.1%, of which eyes received MMC >3 min had marginally significant IOP reduction, with qualified success of 83.3% compared to 61.5% in MMC <3 min at 1 year ( P = 0.059). Our results were comparable with studies by Rodriguez-Una et al .,[17] Meyer et al .,[10] and Yun and Cha[18] with similar MMC dosing schedule which had a longer follow up.…”

“…Once surgical failure sets in, all measures are taken to re-establish IOP control beginning with medical management, digital maneuvers to improve the aqueous outflow, bleb needling, or further surgical intervention like repeat trabeculectomy or tube implant surgery. [891011] Once the primary surgery fails, the success rate of subsequent surgery becomes low. Under such circumstances, one may have to choose to perform a repeat trabeculectomy with antimetabolites or a tube implant surgery.…”

“…The success of repeat trabeculectomy is documented to be around 30–60%, however, none in the Indian subcontinent. [10121314] The results of tube versus trabeculectomy (TVT)[11] study did not show a clear superiority in IOP reduction between the two groups, however consistent IOP control with lesser re-surgeries were seen with drainage implants. This makes it imperative to understand if this is truly the best option especially in countries where patients may not be economically sound and only a few surgeons may be trained in drainage implants.…”

Baerveldt shunt surgery versus combined Baerveldt shunt and phacoemulsification: a prospective comparative study

“…The total number of previous glaucoma filtration surgeries was greater in the BT group due to the disproportionately greater number of deep sclerectomy patients. Consequently, there was greater risk of conjunctival scarring 19. However, the BT group has less bleb failure, thereby strengthening the clinical significance of the results.…”

Prolidase Enzyme Activity in Conjunctiva and Pterygium Tissues

“…Collagen production occurs in postoperative fibrosis [ 26 ]. Mitomycin-C, which is used postoperatively, prevents scarring by hindering fibroblast proliferation and migration [ 27 , 28 ]. While there is no prolidase activity in conjunctiva, there may be fibroblast-derived prolidase activity during scar formation after trabeculectomy.…”