The Efficacy and Safety of Mitomycin C and Releasable Suture in Glaucoma Triple Procedure

PURPOSE: To evaluate the clinical efficacy and safety of short-term application of mitomycin C and releasable scleral flap sutures. METHODS: The clinical outcome and complications were evaluated in 62 eyes undergone glaucoma triple procedure(Group A: with mitomycin C and releasable suture, Group B: with mitomycin C only, Group C: with releasable suture only, Group D: without mitomycin C and releasable suture). RESULTS: The mean postoperative intraocular pressure was relatively lower in group A and B than that of group C and D(p=0.868). The most common complication was posterior capsular opacity, and other complications were cystoid macular edema, hypotony, choroidal detachment and bleb leakage. CONCLUSIONS: The glaucoma triple procedure using mitomycin C and releasable suture could be recommended to be safe and effective on controlling the early postoperative and long-term intraocular pressure for treating the patients with coexisting cataract and glaucoma, and the use of releasable suture could lower the incidence of postoperative complications such as hypotony.

A Comparison between 3.2mm and 5.5mm Incision Phacoemulsification, Intraocular Lens Insertion and Trabeculectomy with Mitomycin C(MMC)

We compared the results of phacoemulsification, intraocular lens(IOL) insertion, and trabeculectomy with mitomycin(MMC) in patients receiving either 3.2mm or 5.5mm incision. Our study revealed that the surgicalresults were comparable between the 3.2 and 5.5mm incision groups in terms of number of glaucoma medicatins, intraocular pressure(IOP) control, visual acuity except visual recovery in early period. The 3.2mm incision group showed stastically significant advantage in early visual recovery than the comparison group(P<0.05, Wilcox rank test). The incidence of anterior capsular opacity was significantly higher in 3.2mm incision group, requiring YAG capsulectomy for better vision than in 5.5mm group. This study suggests that both 3.2 and 5.5mm incision glaucoma triple procedures combined with Mitomycin C(MMC) may provide excellent postoperative IOP control and visual recovery without significant complication I intermediate follow-up period.

Clinical Analysis of Glaucoma Triple Procedure of Extracapsular Cataract Extraction and Posterior Chamber Intraocular Lens Implantation Combined with Trabeculectomy

Glaucoma triple procedure of extracapsular cataract extraction and posterior chamber intraocular lens implantation combined with trabeculectomy which was undergone in 21 eyes(20 cases) since May 1984, were reviewed. The results as follows. 1. In the distribution of sex and age of 20 patients, 16 patients(75%) were male, and seventies, which were most common, were 9 patients(45.0%); fifties, 5; forties, 1; thirties, 1. The average age was 63.9 years old. 2. In type of glaucoma, chronic open angle glaucoma which was most common, were 14 eyes(66.7%); chronic angle closure glaucoma, 5 eyes(23.8%); aphakic glaucoma, 1 eye(4.8%); secondary glaucoma, 1 eye(4.8%). 3. Visual acuity improved in 20 eyes but unchanged in 1 eye, and 14 eyes(66.7%) achieved visual acuity 0.5 or better. 4. Preoperative mean intraocular pressure(IOP)was 20.9mmHg and postoperative mean IOP was 6.1, 4.5mmHg lower than preoperative level at 2 and 6 months res pectively. 5. 2.1 glaucoma medications was needed preoperatively and 0.7, 0.8 was needed at postoperative 2 and 6 months respectively. 6. There were no serious complications that affected the visual acuity. However minor complications were as follows. Hyphema were 4 eyes(19.0%); mydriasis, 3 eyes(14.3%); flat chamber, 1 eye(14.3%); flat chamber, 1 eye(4.8%); cystoid macular edema, 1 eye(4.8%).