Fumero GFY, Cárdenas CD, Fernández AL, Piloto DI, Vidal CM, Obret MI, Díaz ÁY

Language: Spanish
References: 18
Page: 189-198
PDF size: 114.35 Kb.

ABSTRACT

Objective: to determine the medium-term effectiveness of subconjuntival mitomicyn- C associated to needle revision on encapsulated filtering bleb after trabeculectomy.
Methods: prospective, descriptive and observational case series study (30 eyes, 30 patients) with a history of Tenon cyst after short term trabeculectomy (1 month -1year). These patients underwent needle revision associated to subconjuntival 0,01 % mitomycin injection to completing three doses in every other day. The intraocular pressure and the use of hypotensive drops preoperatively and postoperatively were evaluated seven days, one month, three months, one year and two years after the procedure. The success of intervention was defined as total when the intraocular pressure was less than 21 mmHg without hypotensive drops and partial with hypotensive drops. Surgical complications were recorded.
Results: the mean preoperative intraocular pressure decreased significantly from 27,06 ± 5,2 mmHg to 13,10 ± 3,3 mmHg, 14,83 ± 3,68 mmHg and 16,70 ± 3,38 mmHg one week, one month and three months after surgery and remained stable (16,70 ± 2,18 mmHg) for 2 years, p ‹ 0,001 for each preoperative and postoperative comparison; this represented an intraocular pressure reduction of 51,8 %; 44,4 % and 37 % after one week, one month, and up to 2 years, respectively. The mean number of hypotensive drops lowered significantly from 2,0 ± 0,0 (preoperative) to 0,4 ± 0,0 (two years after surgery), being p ‹ 0,001. Total success was attained in 70 % of cases and partial in 30 % after 2 years. Surgical complications were subconjuntival haemorrhage (in all patients), atalamy (40 %) and positive Seidel index (26,7 %).
Conclusion: subconjuntival mitomicyn-C injection-associated needle revision for encapsulated bleb reduces intraocular pressure by 37 % during the first 2 years after the procedure with minimal complications.

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