Comparative study between trabeculectomy with collagen implant versus trabeculectomy with mitomycin C in patients requiring glaucoma surgery at a tertiary care hospital in Rajasthan

Abstract

Glaucoma is a chronic multifactorial degenerative optic neuropathy and is the second leading cause of irreversible blindness worldwide. Aim of this study was to study trabeculectomy with collagen implant versus trabeculectomy with mitomycin C in patients requiring glaucoma surgery50 eyes of 44 patients were assigned randomly to undergo trabeculectomy either with collagen implant (study group) or with MMC (mitomycin C)(control group). Preoperative data included age, gender, IOP (intraocular pressure) and number of preoperative medications. Postoperatively IOP, number of glaucoma medications and postoperative complications if any were recorded on follow up at seven days, one month and three months. Proportion was compared using chi square test while mean using student t test.Baseline characteristics were matched. The intervention arm had lower IOP post operatively at 3 months (11.84±4.21 vs 17.72±5.93, p = 0.002) but not at day 7 (17.14±9.88 vs 21.37±11.07, p=0.12), 1 month (16.77±11.54 vs 22.91±9.62 p = 0.05); lesser need of anti-glaucoma medication (0.48±0.77 vs 1.95±1.26 p = 0.0001); more complete treatment success (15 vs 7), lower treatment failure (1 vs 4), less Postoperative complications were seen in cases than controls, flat AC(12%vs16%), Hyphema (4% vs 8%); However hypotony were comparable(12%). This study supports superiority of collagen implant with trabeculectomy as opposed to trabeculectomy with mitomycin C in terms of better clinical outcome and reduced post operative antiglaucoma medications.