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ORIGINAL ARTICLE
Year : 2017  |  Volume : 9  |  Issue : 1  |  Page : 16-21

Comparative evaluation of trabeculectomy with releasable suture versus subconjunctival mitomycin C in post keratoplasty glaucoma


Department of Ophthalmology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand, India

Correspondence Address:
Anuradha Raj
Department of Ophthalmology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun, Uttarakhand
India
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DOI: 10.4103/sjopthal.sjopthal_4_17

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Aim: The aim of the study was to compare the efficacy of trabeculectomy with releasable suture (RS) and trabeculectomy with mitomycin C (MMC) in post keratoplasty glaucoma (PKG). Methods: This observational study was conducted for the patients who developed refractory PKG. Patients who underwent trabeculectomy with RS and with MMC 0.2mg/ml for 2 minutes under the sclera flap were randomly divided into two groups as group I and II respectively. Postoperative follow up of all patients was complete till 6 months for intraocular pressure (IOP) and complications if any. The criteria for surgical success and failure were defined as complete success if final IOP <21 mm Hg achieved without anti-glaucoma medication (AGM), qualified success as achieving the same IOP criteria with AGM and failure as IOP > 21 mm Hg with more than one medications. Results: A total of 52 eyes of 52 patients were included with 26 eyes in each group. Most frequent indication for PK was corneal opacity 25(48.07%). The preoperative mean IOP was 42.11 ± 5.90mmHg and 46.38 ± 8.51mmHg on three AGM in group I and group II respectively. The mean IOP was lowered after both the procedures significantly at all the postoperative follow ups (P=0.000). In group I, the IOP stabilized to 13.12 ± 5.23mmHg by two weeks and remained same till three months with further mild rise in IOP to 17.13 ± 4.28mmHg at six months. In group II, the IOP decreased to 11.27 ± 4.35mmHg on Ist POD and it stabilized at around 22mmHg at two weeks and remained same till six months of follow up. Conclusion: IOP control in trabeculectomy with RS was very good till three months as compared to trabeculectomy augmented by MMC with comparable results at six months of follow up.


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