Deep sclerectomy-MMC versus subscleral trabeculectomy-MMC in highly myopic eyes with primary open angle glaucoma

Abstract

Purpose The aim of this study was to assess intraocular pressure (IOP) control and postoperative complications in deep sclerectomy (DS) with mitomycin-C (MMC) versus subscleral trabeculectomy with MMC in highly myopic eyes with primary open angle glaucoma (POAG). Design This study was a nonrandomized, interventional, comparative, prospective study. Setting The study was conducted at Ain-Shams University Hospitals. Patients and methods In total, 24 eyes of 12 highly myopic patients with medically uncontrolled POAG were included in this study. Best corrected visual acuity, degree of myopia, IOP, and visual field were assessed, and slit lamp examination was also performed. One eye of each patient was included in the DS-MMC group (group I) and the other eye in the subscleral trabeculectomy-MMC group (group II). All 24 eyes were followed up for a minimum period of 9 months. Complete success was defined as an IOP of up to 22 mmHg without glaucoma medication or needling procedures. Results The mean follow-up period was 11.2±1.7 months. The mean preoperative IOP dropped from 29.5±4.1 to 19.8±1.34 mmHg (32.9%) in group I and from 29.5±2.96 to 20.2±3.9 mmHg (31.5%) in group II by the end of the mean follow-up period. The difference was statistically significant compared with the baseline in both groups (P Conclusion DS-MMC is an effective surgical modality for myopic eyes with POAG. There were relatively fewer complications with DS-MMC. We favor DS for young myopic patients with POAG and a clear lens.