Journal article
A Randomized Study of Mitomycin Augmentation in Combined Phacoemulsification and Trabeculectomy
Ophthalmology (Rochester, Minn.), Vol.104(4), pp.719-724
04/1997
DOI: 10.1016/S0161-6420(97)30246-2
PMID: 9111269
Abstract
Purpose: The purpose of the study is to determine whether the intraoperative application of subconjunctival mitomycin C (MMC), during combined phacoemulsification and trabeculectomy, is an effective means of improving filtration, defined as overall lower intraocular pressure (IOP) and less antiglaucoma medication use.
Methods: Twenty-nine patients with a visually significant cataract and glaucoma were randomized, in a double-masked fashion, to receive intraoperative MMC (0.5 mg/ml) or placebo.
Results: Follow-up ranged from 6 to 30 months (mean, 20 months). Postoperative visual acuity at 1 year was 20/40 or better in 14 of 15 eyes operated on in the placebo group and 13 of 14 eyes operated on in the MMC group. Intraocular pressure at 8 months averaged 15.2 ± 1.5 mmHg in the placebo-treated eyes versus 12.3 ± 1.6 mmHg in the MMC-treated eyes. At 12 months, lops averaged 16.2 ± 1.5 mmHg in the placebo-treated eyes versus 12.6 ± 1.0 mmHg in the MMC-treated eyes. On average, the MMC group had postoperative IOP levels 3.0 mmHg lower than did the placebo group (P = 0.04) throughout the study. In the placebo group, laser suture lysis was required in a greater number of patients (80% versus 43%) and to a greater extent (mean = 2.0 versus 0.7 suture lysed) (P < 0.05). At 12 months, 5 of the 15 patients in the placebo group required an average of 1.8 medications for IOP control, whereas 0 of the 14 patients in the MMC group needed IOP-lowering medications. A late endophthalmitis developed through an intact bleb in one patient in the MMC group; otherwise, complications were minimal in each group.
Conclusion: These results suggest that intraoperative MMC application, during combined phacoemulsification and trabeculectomy surgery, does improve early filtration as shown by overall lower lops and less antiglaucoma medication use.
Details
- Title: Subtitle
- A Randomized Study of Mitomycin Augmentation in Combined Phacoemulsification and Trabeculectomy
- Creators
- Dean W Carlson - Department of Ophthalmology, Wilford Hall Medical Center, Lackland AFBWallace L.M Alward - Department of Ophthalmology, College of Medicine, University of Iowa, Iowa CityJames P Barad - Department of Ophthalmology, Wilford Hall Medical Center, Lackland AFBM. Bridget Zimmerman - Department of Preventive Medicine and Environmental Health (Division of Biostatistics), College of Medicine, University of Iowa, Iowa CityBenita L Carney - Department of Ophthalmology, College of Medicine, University of Iowa, Iowa City
- Resource Type
- Journal article
- Publication Details
- Ophthalmology (Rochester, Minn.), Vol.104(4), pp.719-724
- Publisher
- Elsevier Inc
- DOI
- 10.1016/S0161-6420(97)30246-2
- PMID
- 9111269
- ISSN
- 0161-6420
- eISSN
- 1549-4713
- Language
- English
- Date published
- 04/1997
- Academic Unit
- Biostatistics; Ophthalmology and Visual Sciences
- Record Identifier
- 9983997338202771
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