Comparison of surgical outcomes of sponge-applied vs subconjunctival injection of mitomycin C during combined phacoemulsification and trabeculectomy surgery in Asian eyes

Session Details

Session Title: Presented Poster Session: Glaucoma I

Venue: Poster Village: Pod 3

First Author: : X.Guo SINGAPORE

Co Author(s): :    B. Ang   P. Lim   B. Lim   V. Yong   H. Wong   L. Yip        

Abstract Details

Purpose:

To compare the outcomes of phaco-trabeculectomy with intra-operative sponge-applied versus subconjunctival injection of mitomycin-C (MMC) in Asian eyes.

Setting:

A single-centre, retrospective review of consecutive eyes which underwent phaco-trabeculectomy performed by 4 surgeons, from January 2013 to June 2014 in Singapore.

Methods:

Data from 108 eyes of 101 subjects were collected from pre and post-operative clinical charts. The mean age was 70 years. 65 (60.2%) had primary open angle glaucoma, 25 (23.2%) had primary angle-closure glaucoma and 18 (16.7%) had normal tension and secondar glaucoma. Outcome measures included intraocular pressure (IOP), number of glaucoma medications, best corrected visual acuity (BCVA) and post-operative complications. Outcomes were compared at 1, 6, and 12 months postoperatively. 24 (22.3%) eyes received 0.02% subconjunctival MMC injection (‘Group 1’) and 84 (77.8%) received 0.04% sponge-applied MMC (‘Group 2’).

Results:

In both groups, there was a reduction in IOP at both 6 and 12 months post-operatively (12 months: Group 1, -2.8 ± 5.36 mmHg, p=0.052; Group 2, -5.7 ± 6.39 mmHg, p=0.004). The mean number of glaucoma medications for Group 1 was reduced from 2.84 ± 0.96 pre-operatively to 0.37 ± 0.50 (p=0.002) at 12 months, and for Group 2, from 2.74 ± 0.73 to 0.18 ± 0.56 (p<0.001). There was no difference in reduction of medications and BCVA between both groups. Post-operative bleb manipulation procedures (bIeb needling, flap lift, bleb revision) were required for both groups.

Conclusions:

Phaco-trabeculectomy with either sponge-applied or subconjunctival MMC injection is effective in lowering the IOP and the number of glaucoma medications up to 12 months post-operatively. There was no significant difference in outcomes between both groups.

Financial Disclosure:

None