Original Paper

Deep Sclerectomy versus Trabeculectomy with Low-Dosage Mitomycin C: Four-Year Follow-Up
Salvatore Cillino, Francesco Di Pace, Alessandra Casuccio, Giovanni Cillino, Gaetano Lodato

Dipartimento di Neuroscienze Cliniche, Sezione di Oftalmologia, Università di Palermo, Palermo, Italia

Address of Corresponding Author

Ophthalmologica 2008;222:81-87 (DOI: 10.1159/000112623)

  Key Words

• Deep sclerectomy
• Trabeculectomy
• Mitomycin C
• Intraocular pressure
• Glaucoma surgery

  Abstract

Aims: To compare the long-term effects of low-dosage mitomycin C (MMC) in both deep sclerectomy (DSMMC) and trabeculectomy (TPMMC) on intraocular pressure (IOP). Methods: Analysis of extended follow-up of data from a prospective clinical trial. Forty patients were originally randomised to undergo either DSMMC (19 eyes) or TPMMC (21 eyes). Follow-up was performed at postoperative day 1, weeks 1, 2 and 3, as well as months 1, 3, 6, 9, 12, 18, 24, 36 and 48. Two- to three-week data were not included in the statistical analysis. Postoperative complications, number of antiglaucoma medications and IOP were recorded at each visit. Complete (no medications) and qualified (with or without medications) successes were assessed at 2 target IOPs (21 and 17 mm Hg) and evaluated by Kaplan-Meier curves. Results: At 48 months, the mean IOP (± SD) was 17.6 ± 3.4 and 17.8 ± 3.6 mm Hg in the DSMMC and TPMMC eyes, respectively, a significant reduction from preoperative IOP in each group (p < 0.0005). Complete success was achieved at the 21 mm Hg target IOP in 10 (52.6%) and 14 (66.6%) eyes and qualified success in 15 (78.9%) and 18 (85.7%) eyes in the DSMMC and TPMMC groups, respectively. There were no differences in the Kaplan-Meier curves. Hypotony and shallow anterior chamber were significantly more frequent in the TPMMC group. Conclusions: Either procedure controlled IOP efficaciously at our endpoint. Low-dosage MMC can be considered a mild enhancement of deep sclerectomy IOP-lowering effect.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Prof. Salvatore Cillino
Dipartimento di Neuroscienze Cliniche, Sezione di Oftalmologia
Università di Palermo, Via Liborio Giuffrè No. 13
IT-90127 Palermo (Italy)
Tel. +39 091 655 3904, Fax +39 091 626 1438, E-Mail cillino@iol.it

  Article Information

Received: September 9, 2006
Accepted after revision: December 21, 2006
Published online: February 22, 2008
Number of Print Pages : 7
Number of Figures : 3, Number of Tables : 4, Number of References : 37