Mitomicina c en la esclerectomía profunda no perforante / Mitomycin C in non-penetrating deep sclerostomy

RESUMEN

Nuestro propósito en este trabajo es evaluar la eficacia de la Mitomicina C como inhibidor fibroblástico en la esclerectomía profunda no perforante (EPNP). Se realizó EPNP en 40 ojos con glaucoma crónico primario; 20 sin Mitomicina C y 20 con aplicación tópica intraoperatoria de Mitomicina C (0,5 mg/mL) durante 5 min, evaluándose al 1, 6 y 12 meses. En la EPNP sin Mitomicina C la PIO se redujo de 27,40 ± 4,76 mmHg a 15,80 ± 2,50 mmHg requiriendo betabloqueadores 5 ojos (25 %) a diferencia (p=,0001) de una reducción de 27,35 ± 2,91 mmHg a 7,15 ± 1,67 mmHg sin necesidad de betabloqueadores; con ampolla de filtración extensa, pálida, transparente y avascular y escasas complicaciones como hifema y dehiscencia conjuntival segmentaria. La EPNP con Mitomicina C fue más efectiva en el control de la PIO y su monodosificación tópica transoperatoria bien tolerada por los pacientes.

ABSTRACT

We intend in this paper to assess the effectiveness of Mitomycin C as a fibroblastic proliferation inhibitor in the non-penetrating deep sclerostomy (NPDS). This procedure was performed in 40 eyes with primary chronic glaucoma, 20 of them were treated with intraoperative topycal Mitomycin C at 0,5 mg/mL for five minutes and 20 were not applied this drug. They were followed up and assessed one, six and twelve months after the surgery. In the NPDS without mitomycin C group, intraocular pressure was reduced from 27,40 ± 4,76 mmHg to 15,80 ± 2,50 mmHg, but 5 eyes required betablockers compared to a reduction from 27,35 ± 2,91 mmHg to 7,15 ± 1,67 mmHg without betablockers in the NPDS with Mitomycin C group, which presented and extensive, pale, transparent and avascular filtering ampulla and slight complications such as hyphema and dehiscence. The NPDS with mitomycin C was more effective in controlling intraocular pressure and transoperative topycal monodosage of this drug was well tolerated by the patients.