Phacoemulsification combined with deep sclerectomy augmented with mitomycin and amniotic membrane implantation in chronic primary open angle glaucoma with cataract

Electronic Physician

卷:8

关键词: phacoemulsification;    amniotic membrane implantation;    MMC application;    intraocular pressure;    deep sclerectomy;   

DOI  :  10.19082/2218

来源: DOAJ

【 摘 要 】

Objective: The aim of this study was to determine the safety and efficacy of combined phacoemulsification plusIntraocular lens (IOL) implantation with deep sclerectomy augmented with mitomycin C (MMC) and sub-flapimplantation of amniotic membrane for the management of uncontrolled, chronic, primary open-angle glaucomapatients.Methods: This prospective study included 41 patients with chronic, primary, open-angle glaucoma and cataractuncontrolled with medical treatment who underwent combined phacoemulsification augmented with mitomycinC (MMC) application and amniotic membrane implantation under the scleral flap. Intraocular pressure (IOP),visual acuity, glaucoma medications, stabilization of visual field, complications, and viability of the success ratewere assessed a 36-month follow-up period.Results: The mean age of cases was 54.8 ± 5.3 years. Sixty-one percent of cases were males, and 39% werefemales. The mean IOP decreased from 23.8 ± 1.8 mmHg preoperatively to 16.8 ± 2.3 mmHg postoperatively.The overall success rate was 97.5, 95, and 92.7% in the first, second, and third year, respectively. The overallsuccess rate was 90% in the first year, but that decreased to 85.3 and 78% in the second and third year,respectively. Qualified success was 7.5, 10, and 14.7% in the first, second, and third year, respectively. Failurewas recorded as 2.5, 5, and 7.3% in the first, second, and third year, respectively. IOP reduction was sustainedthrough the follow-up period. Visual acuity improved from 0.13 ± 0.06 to 0.9 ± 0.07 (p < 0.001). The visual fieldimproved significantly in the first assessment, from 14.0 ± 2.7 preoperatively to 12.6 ± 2.6 at three monthspostoperatively (p < 0.001), after which it became stable for the remainder of the follow-up period. One hundredpercent of cases were on three anti-glaucoma drugs preoperatively, while postoperatively, 12.2% were on threedrugs, 4.2% were on two drugs, and 82.9% were controlled without anti-glaucoma treatment. There were minorpostoperative complications all of which were minor, such as a spike in the post-operative IOP and the formationof fibrinous material in the anterior chamber, both of which were treated medically without any adverse effects onthe final results.Conclusion: Amniotic membrane implantation in conjunction with MMC application may be an effectivealternative to expensive implants in deep sclerectomy combined with phacoemulsification, and this approach canbe used safely in advanced cases

【 授权许可】

Unknown