Dados do Trabalho

Título

RESULTS OF TRABECULECTOMY WITH SUBCONJUNCTIVAL MITOMYCIN C IN DIFFERENT TYPES OF GLAUCOMAS: A RETROSPECTIVE OBSERVATIONAL STUDY.

Resumo

Introduction:
Trabeculectomy is considered to be the gold standard for the surgical treatment of glaucoma, the use of antimetabolites decreases postoperative fibrosis, improving postoperative results. Mitomycin C (MMC) was traditionally used with sponges, in different doses and exposure times, but satisfactory results were also found with the use of subconjunctival injection of MMC.

Objective:
Analyze postoperative results of trabeculectomy with the same technique in different types of glaucoma.

Methods:
A retrospective observational study was carried out on trabeculectomies performed at the Hospital Italiano de Buenos Aires from 2018 to 2022. Intraocular pressure (IOP) and the number of drugs used were recorded prior to surgery, 6 and 12 months after. Patients were categorized by glaucoma type: primary open-angle (POAG), pseudoexfoliation (PEX), other types, or reoperation. All surgeries were performed by the same surgeon and with the same technique, using 0.1 ml of subconjunctival injection of MMC 0.2 mg/ml at the beginning of surgery.

Results:
Involving 163 patients (mean age: 71.37 ±15.99), predominantly women (58.64%). The most common type was POAG (38.27%), followed by PEX (29.62%), others (21.60%) and reoperations (10.49%). Preoperatively, the mean IOP was 24.70 mmHg (±7.45), and 3.09 drugs (±0.78) were used. At 12 months post-surgery, IOP dropped to 12.91 mmHg (±5.00), and drug use reduced to 0.56 (±1.28). PEX exhibited the most substantial IOP decrease (54.94%), while reoperations showed the least (34.94%). Drug use diminished across all groups, notably in other types (93.05%).

Conclusions:
Our results show that the greatest indication for trabeculectomy is POAG and PEX. The PEX group presented higher IOP at the beginning and a greater reduction was seen compared to the rest.

Referências Bibliográficas

1. Al Habash A, Aljasim LA, Owaidhah O et al. A review of the efficacy of mitomycin C in glaucoma filtration surgery. Clin Ophthalmol. 2015 Oct 20;9:1945-51.
2. Guimarães ME, de Pádua Soares Bezerra B, de Miranda Cordeiro F et al. Glaucoma Surgery with Soaked Sponges with Mitomycin C vs Sub-Tenon Injection: Short-term Outcomes. J Curr Glaucoma Pract. 2019 May-Aug;13(2):50-54.
3. Kandarakis SA, Papakonstantinou E, Petrou P et al. One-Year Randomized Comparison of Safety and Efficacy of Trabeculectomy with Mitomycin C Sub-Tenon Injection versus Mitomycin C-Infused Sponges. Ophthalmol Glaucoma. 2022 Jan-Feb;5(1):77-84.