Efficacy and tolerability of nonpenetrating glaucoma surgery augmented with mitomycin C in treatment of open-angle glaucoma: a meta-analysis

Cheng, Jin-Wei; Xi, Gui-Lin; Wei, Rui-Li; Cai, Jun; Li, You

doi:10.3129/i08-165

Cited by 21 publications

(13 citation statements)

References 28 publications

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“…However, it is frequently accompanied with short- and long-term postoperative complications such as hypotony, bleb leaks, cataract formation, avascular filtering blebs, thinning of the conjunctiva, subsequent blebitis, choroidal effusions, maculopathy, and endophthalmitis [9]. Therefore, there is still a need for other adjuvants with similar or better efficacy and less complications.…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study: The Use of Collagen Implant versus Mitomycin-C in Combined Trabeculotomy and Trabeculectomy for Treatment of Primary Congenital Glaucoma

Singab

Mohammed

Iqbal

et al. 2017

Journal of Ophthalmology

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Purpose To compare Ologen implant versus mitomycin-C (MMC) in combined trabeculotomy and trabeculectomy as a treatment of primary congenital glaucoma. Setting Sohag University Hospital, Egypt. Design A prospective comparative study. Methods Thirty-four eyes of twenty-one patients with primary congenital glaucoma were included in this study. All patients were subjected to preoperative evaluation including complete anterior segment examination under general anesthesia. The patients were divided into two groups: patients of the first group (group A) underwent combined trabeculotomy and trabeculectomy with Ologen implantation while those of the second group (group B) underwent combined trabeculotomy and trabeculectomy with MMC application. Results Postoperatively, the IOP in group A was as follows: 8 eyes developed IOP levels less than 14 mmHg (complete success), 3 eyes had levels between 14 and 16 mmHg (accepted result), 2 eyes had levels between 16 and 20 mmHg (guarded result), and only 2 eyes showed levels exceeding 20 mmHg (failed procedure), while in group B, 7 eyes showed complete success, 3 eyes had accepted result, 3 eyes had guarded result, and 2 eyes had failed procedure. Conclusion Ologen is a safe and effective adjuvant in combined trabeculotomy and trabeculectomy for treatment of primary congenital glaucoma.

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Section: Introductionmentioning

confidence: 99%

A Comparative Study: The Use of Collagen Implant versus Mitomycin-C in Combined Trabeculotomy and Trabeculectomy for Treatment of Primary Congenital Glaucoma

Singab

Mohammed

Iqbal

et al. 2017

Journal of Ophthalmology

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“…Recent systematic reviews have demonstrated significant enhancement of success rates and postoperative IOP through the intraoperative use of MMC during glaucoma filtering surgery [6], [8], [9]. However, it is frequently accompanied by short- and long-term complications such as hypotony, bleb leaks, cataract formation, avascular filtering blebs, thinning of the conjunctiva, subsequent blebitis, and endophthalmitis [10].…”

Section: Introductionmentioning

confidence: 99%

Ologen Implant versus Mitomycin C for Trabeculectomy: A Systematic Review and Meta-Analysis

Wang

Zhang

et al. 2014

PLoS ONE

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ObjectiveTo evaluate the application of the Ologen implant compared to mitomycin C (MMC) on the outcome of trabeculectomy and to examine the balance of risks and benefits.MethodsA systematic literature search (Pubmed, Embase, the Cochrane Library, and the Chinese Biomedicine Database) was performed. Randomized controlled trials comparing the Ologen implant with MMC in trabeculectomy were selected. The efficacy measures were the weighted mean differences (WMDs) for the intraocular pressure reduction (IOPR), the reduction in glaucoma medications, and the relative risks (RRs) for success rates. The tolerability measures were RRs for adverse events. The pooled effects were calculated using the random-effects model.ResultsSeven randomized controlled trials including 227 eyes were included in this meta-analysis. The WMDs of the IOPR comparing the Ologen group with the MMC group were −2.98 (95% Cl: −5.07 to −0.89) at one month, −1.41 (−3.72 to 0.91) at three months, −1.69 (−3.68 to 0.30) at six months, −1.94 (−3.88 to 0.01) at 12 months, and 0.65 (−2.17 to 0.47) at 24 months. There was no statistically significance except at one and 12 months after surgery. No significant difference in the reduction in glaucoma medications or complete and qualified success rates were found. The rates of adverse events also did not differ significantly between Ologen and MMC.ConclusionsThe Ologen implant is comparable with MMC for trabeculectomy in IOP-lowering efficacy, reduction in the number of glaucoma medications, success rates, and tolerability. However, the results should be interpreted cautiously since relevant evidence is still limited, although it is accumulating. Further large-scale, well-designed randomized controlled trials are urgently needed.

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“…Yapılan ça-lışmalarda, her ne kadar yeni teknikler tanımlansa da, penetran cerrahiler daha yüksek komplikasyon oranları, nonpenetran cerrahiler de daha düşük etkinlikle birlikte anılmaktadır [6,7]. Yapıl-mış birçok prospektif randomize çalışmada, GİB'in uzun dönem etkin bir şekilde düşürülmesinden taviz verilerek, ilk seçenek olarak komplikasyonların daha az yaşandığı nonpenetran cerrahilerin tercih edilmesi tavsiye edilmektedir [8,9].…”

Section: Discussionunclassified

Comparative Efficacy and Safety Profile Between Trabeculectomy and Deep Sclerectomy

Özgönül¹

2014

Ann Clin Anal Med

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ÖzetGiriş: Bu çalışmanın amacı, ilaç tedavisiyle kontrol altına alınamamış glokomlu olgularda, trabekülektomi ve derin sklerektomi tekniklerini, postoperatif dönemde etkinlik ve komplikasyon gelişimi yönünden karşılaştırmaktır. Gereç ve Yöntem: Kliniğimizin glokom biriminde takipli hastaların tıbbi kayıt-ları geriye dönük incelendi. İlaç tedavisiyle glokomu kontrol altına alınama-yan 23 hastanın 29 gözü çalışmaya dahil edildi. Hastaların kullandığı ilaç sayısı, göz içi basıncı, görme keskinliği ve takip süresi, preoperatif, postoperatif 1.gün, 7.gün, 1.ay, 3.ay, 6.ay, 12.ay ve en son muayenede kaydedildi. Postoperatif komplikasyonlar kaydedildi. Bulgular: Trabekülektomi grubunda 21 göz, derin sklerektomi grubunda 8 göz bulunuyordu. Gruplar arasında preoperatif ilaç kullanımı, göz içi basıncı, görme keskinliği, takip süresi, postoperatif takip süresi, ilaç sayısı, görme keskinliği, hedef göz içi basıncı değerine ulaş-ma yönünden fark yoktu. Göz içi basıncı düşüşü yönünden gruplar karşılaştı-rıldığında postoperatif 1 (p=0.038) ve 7. gün (p=0.045) istatistiksel anlamlı fark vardı ve bu düşüş trabekülektomi grubunda daha fazlaydı. Trabekülek-tomi grubundaki üç hipotoni olgusundan başka komplikasyon görülmedi. Tartışma: Hem trabekülektomi, hem de derin sklerektomi takip sonunda göz içi basıncı kontrolü sağlamıştır. Erken dönemde etkin göz içi basıncı düşüşü için trabekülektomi, hipotoniden kaçınmak için derin sklerektomi tercih edilebilir. Anahtar KelimelerDerin Sklerektomi; Glokom; Trabekülektomi Abstract Aim: The purpose of this study is, to compare the efficacy and safety of nonpenetrating deep sclerectomy and trabeculectomy in the management of medically uncontrolled glaucoma. Material and Method: We retrospectively reviewed the medical records of the patients followed up our glaucoma policlinic. Twenty-nine eyes of 23 patients which have medically uncontrolled glaucoma were included in the study. Number of medications, intraocular pressure, visual acuity, and follow-up time were recorded preoperatively, postoperative 1st day, 7th day, 1st month, 3rd month, 6th month, and the last visit. Postoperative complications were recorded. Results: Trabeculectomy was performed in 21 eyes, deep sclerectomy in 8 eyes. There was no difference between groups in terms of preoperative number of medications, intraocular pressure, visual acuity, follow-up time, postoperative follow-up time, number of medications, visual acuity and access to target intraocular pressure. The intraocular pressure reduction was significantly differ in the two groups on the day 1 (p=0,038) and 7 (p=0,045) and the reduction was higher in trabeculectomy group. Postoperative complications included three cases of hypotonia in the trabeculectomy group. Discussion: Both techniques, trabeculectomy and deep sclerectomy, control intraocular pressure at our end point. For early reduction of intraocular pressure, trabeculectomy, in order to avoid hypotonia deep sclerectomy should be preferred.

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Efficacy and tolerability of nonpenetrating glaucoma surgery augmented with mitomycin C in treatment of open-angle glaucoma: a meta-analysis

Cited by 21 publications

References 28 publications

A Comparative Study: The Use of Collagen Implant versus Mitomycin-C in Combined Trabeculotomy and Trabeculectomy for Treatment of Primary Congenital Glaucoma

A Comparative Study: The Use of Collagen Implant versus Mitomycin-C in Combined Trabeculotomy and Trabeculectomy for Treatment of Primary Congenital Glaucoma

Ologen Implant versus Mitomycin C for Trabeculectomy: A Systematic Review and Meta-Analysis

Comparative Efficacy and Safety Profile Between Trabeculectomy and Deep Sclerectomy

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