Comparative study between trabeculectomy with photodynamic therapy (BCECF-AM) and trabeculectomy with antimetabolite (MMC) in the treatment of primary open angle glaucoma

Poster Details

First Author: A.M. Saeed EGYPT

Co Author(s):                  

Abstract Details

Purpose:

to compare the effect of photodynamic therapy combined with trabeculectomy with the effect of MMC combined with the same procedure in controlling postoperative IOP in patients with medically uncontrolled primary open angle glaucoma (1ry OAG).

Setting:

University hospital, Benha, Egypt.

Methods:

This study was conducted upon 60 eyes that were equally divided into three groups undergoing trabeculectomy; with BCECF-AM, with MMC, and controls. Patients were reviewed postoperatively for clinical evaluation and photo documentation of the blebs with fundus camera and ultrasonic biomicroscopy (UBM). The desirable effect of the adjunctive material was evaluated according to the clinical efficacy, tolerability, and safety by referral to the control group.

Results:

After a mean follow up of 12 months all procedures succeeded to lower the IOP. Both groups A and B showed a lower mean IOP in comparison to group C; however only group B that reached a statistically significant difference (p<0.05). The least change and variation in the IOP over time was recorded in group B. Regarding the efficacy, bleb morphology, UBM reflectivity, the differences was not statistically significant (P>0.05). The mean bleb height and breadth were larger in group B and A in comparison to group C all over the study period. The mean aqueous drainage route was similar in groups A and C but less than in group B at 1 and 3 months postoperatively. However at 12 months, group A showed the largest values. The complications were generally mild and less marked in group A than group B.

Conclusions:

cellular photoablation using BCECF-AM seems to be a feasible new method in combination with glaucoma filtration surgery. MMC might be considered a more potent adjunctive to trabeculectomy in promoting IOP reduction. Photodynamic therapy relatively carries less risk of side effects and complications. It could be considered efficient, tolerable and relatively safe in managing patients with 1ry OAG. Further studies are necessary to optimize the safety and the reliability in the future. FINANCIAL DISCLOSURE?: No