Outcome of trabeculectomy with collagen matrix implant versus mitomycin C in primary glaucoma: A comparative study

Abstract

Background: Glaucoma is a serious vision-threatening condition appropriately called as the silent killer of sight. The effect of postoperative fibrosis on success of filtration surgeries requires modulation of the wound healing process. Aim: The aim of the study was to compare trabeculectomy augmented with collagen matrix implant with mitomycin C in primary glaucoma. Materials and Methods: This prospective, longitudinal, hospital-based, analytical, and interventional study was conducted on 36 eyes of 36 patients. Group 1 included 18 patients who underwent trabeculectomy combined with subconjunctival collagen matrix implant and Group 2 included 18 patients who underwent trabeculectomy augmented with intraoperative mitomycin C (0.04 mg/ml) for 2 min. Each patient underwent detailed ocular examination and comparison was drawn by recording intraocular pressure (IOP), bleb characteristics, and postoperative complications. Results: The cumulative success rates at the end of our study were similar in two groups, 94.44% in Group 1 and 88.89% in Group 2 ( P = 1.000). The mean reduction in IOP at 24 weeks in Group 1 was 18.67 ± 7.59 mmHg and in Group 2 was 21.32 ± 5.84 mmHg. The reduction in IOP was similar between the two groups ( P = 0.290). The mean fall in IOP was 56.46% in Group 1 and 64.70% in Group 2 at 24 weeks. Mean bleb score in Group 1 was 10.33 ± 1.23 and in Group 2 was 8.89 ± 1.41, and the difference was statistically significant ( P = 0.002). Shallow anterior chamber, overfiltration, and hypotony were statistically higher in Group 2 than in Group 1 ( P = 0.041, 0.041, and 0.046, respectively). Conclusion: Collagen matrix implant as an adjuvant to trabeculectomy is noble, safe, and effective option as compared to mitomycin C.

Surgical outcomes of trabeculectomy augmented with sub-Tenon injected mitomycin C

“…In the present study, the shallowing of AC and choroid ablation, the most prevalent complications in patients who underwent trabeculectomy, were reported in 17 (34 %) and 18 (36 %) patients, respectively. A similar prevalence of the shallowing of AC was reported in a recent study by Sharma et al (50), where the shallowing of AC was found in 39 % of patients who underwent trabeculectomy with MMC at a concentration of 0.4 mg/ml. On the contrary, other studies reported that fl at AC was present in less than 10 % of patients who had undergone trabeculectomy regardless of the form of MMC application (18,51).…”