The Efficacy of Nonpenetrating Deep Sclerectomy with 0.02% Mitomycin C

ABSTRACT

PURPOSE: To investigate the efficacy and postoperative complications of nonpenetrating deep sclerectomy(NDS) with 0.02% Mitomycin C(MMC) in primary open-angle glaucoma(POAG). METHODS: After 5 x 5 mm scleral flap was made externally, 0.02% MMC was applied under and above the scleral flap for 2 to 5 minutes. A rectangular internal scleral flap was dissected down to remove Schlemm's canal and juxtacanalicular trabecula. RESULTS: Eleven patients(16 eyes) with POAG underwent the filtering surgery of NDS. The mean follow-up was 10.7(range 6 to 12) months. The mean preoperative intraocular pressure(IOP) was 25.6+/-1.7mmHg(SEM, standard error of mean). The mean postoperative IOP was 12.3+/-1.4, 15.8+/-1.8, 15.5+/-0.9, 16.3+/-1.3, and 18.3+/-1.7 mmHg(SEM) at 1, 3, 6, 9, and 12 months, respectively. Success rate defined as an IOP lower than 21 mmHg without medication was 93.8%, 87.5% and 80.8% at 3, 6 and 12 months, respectively. Complications included two shallow anterior chambers, three wound leakages, two hypotonies and two iris adhesions to sclerectomy site. CONCLUSION: Deep sclerectomy with 0.02% MMC may contribute to a satisfactory result of effect of IOP reduction with fewer complication in management of POAG but has tendency to increase the IOP gradually as time elapsed.