Ab-externo cyclodialysis enhanced trabeculectomy for intractable post-penetrating keratoplasty glaucoma.

Abstract

PURPOSE:

To evaluate the efficacy of cyclodialysis-enhanced Mitomycin c (MMC) trabeculectomy in post-keratoplasty glaucoma.

DESIGN:

Prospective, non-comparative, interventional case series.

METHODS:

A total of 45 eyes of 45 consecutive patients with refractory glaucoma after penetrating glaucoma underwent a cyclodialysis-augmented trabeculectomy with MMC. The visual acuity, intraocular pressure (IOP), corneal clarity, and graft failure were evaluated over a minimum follow-up of 2 years.

RESULTS:

The mean age of the patients was 55.4+/-9.4 years. The cyclodialysis-augmented MMC trabeculectomy procedure resulted in a mean reduction of IOP from 38.9+/-3.9 mmHg (95% confidence interval (CI) 35.9-42.2) at baseline to 11.3+/-2.8 mmHg (95% CI 9.5-12.9), at final follow up (P=0.002). Blebs were avascular, diffuse, and extended posteriorly. Postoperative UBMs revealed the presence of a cyclodialysis with a small associated suprachoroidal effusion and a subconjunctival filtering bleb in all cases.

CONCLUSIONS:

Cyclodialysis-augmented MMC trabeculectomy provides a safe and effective method of lowering IOP in intractable glaucoma following penetrating keratoplasty, without compromising the corneal graft survival and clarity.

• Authors: R Sihota, G Srinivasan, V Gupta
• Journal: Eye (London, England) (Eye (Lond)) Vol. 24 Issue 6 Pg. 976-9 (Jun 2010) ISSN: 1476-5454 [Electronic] England
• PMID: 20010790 (Publication Type: Journal Article)

Chemical References

• Mitomycin

Topics

• Cornea (pathology)
• Female
• Glaucoma (physiopathology, surgery)
• Graft Survival
• Humans
• Intraocular Pressure
• Keratoplasty, Penetrating (adverse effects)
• Male
• Middle Aged
• Mitomycin (administration & dosage)
• Prospective Studies
• Trabeculectomy (methods)
• Visual Acuity