Mitomycin C-Augmented Trabeculectomy Combined With Single-Site Manual Small-Incision Cataract Surgery Through a Tunnel Flap Technique.

Abstract

The objective of this study was to analyze short-term outcomes of mitomycin C-augmented trabeculectomy combined with manual small-incision cataract surgery (MSICS/Trab). This was a retrospective, noncomparative single-center case series. Records of eyes that underwent MSICS/Trab with mitomycin C performed between January 2006 and May 2007 were reviewed. Manual small-incision cataract surgery was done through a superior scleral tunnel; a Kelly punch was used for the trabeculectomy through the tunnel flap, and after a peripheral iridectomy, the scleral tunnel was opposed with two 10-0 nylon sutures. Of the 103 patients, 64 (62.1%) had primary open-angle glaucoma (POAG), 23 (22.3%) had secondary open-angle glaucoma (SOAG), and 16 (15.5%) had chronic angle closure glaucoma (CACG). The minimum follow-up was 6 months, and mean follow-up was 12.6 months. Demographics and mean intraocular pressure (IOP) at the time of surgery (30.4 ± 10.3 mm Hg) were comparable in all 3 groups. Significant visual improvement and reduction in IOP levels from baseline were observed at 6 months (16.64 ± 4.75 mm Hg) irrespective of the type of glaucoma (P = 0.035). Subgroup analysis showed a significant difference in IOP levels of CACG group compared with the SOAG group (P = 0.035) at 6 months. However, no statistically significant difference was observed in IOP comparisons between POAG and CACG groups or POAG and SOAG groups. Mitomycin C-augmented MSICS/Trab appears to be safe and effective technique in tackling coexistent cataract and glaucoma in developing world.