A Randomized Controlled Trial Comparing Subconjunctival Injection to Direct Scleral Application of Mitomycin C in Trabeculectomy

To compare the efficacy of intraoperative scleral application with subconjunctival injection of mitomycin C (MMC) in trabeculectomy. Prospective, randomized, interventional study. This study took place in a single clinical practice in an academic setting. Patients had medically uncontrolled glaucoma...

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Bibliographic Details
Published in:American journal of ophthalmology 2020-12, Vol.220, p.45-52
Main Authors: Do, Jiun L., Xu, Benjamin Y., Wong, Brandon, Camp, Andrew, Ngai, Philip, Long, Christopher, Proudfoot, James, Moghimi, Sasan, Yan, Diya, Welsbie, Derek S., Weinreb, Robert N.
Format: Article
Language:English
Subjects:
Aged
Conjunctiva
Consent
Dissection
Eye examinations
Eye surgery
Failure
Female
Follow-Up Studies
Glaucoma
Glaucoma, Open-Angle - physiopathology
Glaucoma, Open-Angle - therapy
Health Insurance Portability & Accountability Act 1996-US
Humans
Injections
Intraocular Pressure - physiology
Intraoperative Period
Male
Mitomycin - administration & dosage
Morphology
Nucleic Acid Synthesis Inhibitors - administration & dosage
Patients
Prospective Studies
Sclera
Surgeons
Surgical outcomes
Sutures
Trabeculectomy - methods
Treatment Outcome
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Summary:To compare the efficacy of intraoperative scleral application with subconjunctival injection of mitomycin C (MMC) in trabeculectomy. Prospective, randomized, interventional study. This study took place in a single clinical practice in an academic setting. Patients had medically uncontrolled glaucoma as indicated by high intraocular pressure (IOP), worsening visual field, or optic nerve head changes in whom primary trabeculectomy was indicated. Patients were older than 18 years with medically uncontrolled glaucoma and no history of incisional glaucoma surgery. Patients were randomized to MMC delivered by preoperative subconjunctival injection or by intraoperative direct scleral application using surgical sponges during trabeculectomy. Comprehensive eye examinations were conducted at 1 day, 1 week, 6 weeks, 3 months, and 6 months postoperatively. Subconjunctival 5-fluorouracil injections were given postoperatively, as needed. The primary outcome was the proportion of patients who demonstrated IOP of
ISSN:0002-9394
1879-1891
DOI:10.1016/j.ajo.2020.07.002