Trabeculectomy with Long-Term-Stored Mitomycin C in a West Indian Population

Chen, Philip; Basich, Frank M.; Khadem, Erfan

doi:10.1159/000027376

Cited by 5 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The success rates of surgery and the IOP reduction were better in eyes treated with MMC than eyes not treated with this antimetabolite. This lends further support to the idea that MMC does improve the success rate of trabeculectomies, as stated by several authors (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). We believe this high rate of success is not ascribable to the mode of application of MMC but rather to its antimetabolic effect, since similar results have been obtained after other modes of application (3,4,6,13).…”

Section: Discussionsupporting

confidence: 89%

Trabeculectomy with and without Mitomycin-C in a Black African Population

Mwanza

Kabasele

2001

European Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose To evaluate the beneficial effects of intraoperative application of mitomycin-C during trabeculectomy in a black African population in Congo-Kinshasa. Methods A prospective randomized study in 22 eyes (11 patients) with open-angle glaucoma. All patients underwent trabeculectomy with application of mitomycin-C (0.4 mg/ml for 2.5 min) under the scleral flap in the right eye and trabeculectomy alone in the left eye. Assessment of the clinical outcome included intraocular pressure, visual acuity, visual field and complications. The follow-up was 20 months. Success of the filtering surgery was defined as a final IOP of 21 mmHg or lower without antiglaucoma medications and no further glaucoma surgery necessary. Results The success rate of trabeculectomy was 81.8% in eyes treated with mitomycin-C compared with 63.6% in eyes not receiving this drug. Rates of intraocular pressure reduction were 57.9% and 42.9% respectively. Complications occured in 36.3% of the eyes managed with mitomycin-C against 9% in the control eyes. Conclusions Mitomycin-C, as adjunctive treatment during trabeculectomy in black Africans, offers great benefit in lowering IOP, but with a substantial high risk of complications. These data need to be confirmed by further studies in this population.

show abstract

Section: Discussionsupporting

confidence: 89%

Trabeculectomy with and without Mitomycin-C in a Black African Population

Mwanza

Kabasele

2001

European Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…9-11 A surgical trial conducted in St. Lucia (albeit in the pre-antimetabolite era) suggested that guarded trabeculectomy was inadequate to control glaucoma in St. Lucia and that a full-thickness procedure would likely be required 12 ; mitomycin-C-augmented trabeculectomy in black patients in Dominica fared significantly better, although with higher rates of potentially blinding complications such as bleb leak and infection. 13 Is there a role for trabeculoplasty in the developing world? The Glaucoma Laser Trial characterized the safety and efficacy of argon laser trabeculoplasty (ALT) in the management of OAG, 14 and subsequently ALT was shown to be effective in African-derived Caribbean individuals with glaucoma, producing IOP reductions of 6 to 7 mm Hg that endured for 12 or more months in most patients when used as an adjunct to medical therapy.…”

mentioning

confidence: 99%

Selective Laser Trabeculoplasty for the Management of Open-Angle Glaucoma in St. Lucia

Realini¹

2013

JAMA Ophthalmol

View full text Add to dashboard Cite

“…One factor contributing to this is the lack of research publication reporting surgical outcomes in the region, with only two peer-reviewed publications, one each from 1987 and 1998, to date. 15 , 16 …”

Section: Introductionmentioning

confidence: 99%

ReGAE 12: preventing glaucoma blindness in the Caribbean through implementation of the Moorfields Safer Surgery System and skills transfer from the UK to Trinidad and Tobago

Murray¹,

Shah²

2018

OPTH

View full text Add to dashboard Cite

ObjectiveThe objective of the study was to present evidence of successful skills transfer of the Moorfields Safer Surgery System (MSSS) from the UK to Trinidad and Tobago and the safety and efficacy of this technique.MethodsHospital-based retrospective, consecutive, non-comparative case series study of 33 eyes (24 African-Caribbean patients; 16 male patients) with primary open-angle glaucoma undergoing trabeculectomy + mitomycin C (MSSS) by a single surgeon with UK Glaucoma Fellowship training. The clinical outcome measures included intraocular pressure (IOP), bleb morphology, postsurgical interventions, postoperative complications, and best-corrected visual acuity (BCVA) at the final follow-up.ResultsAll patients were self-identified as African-Caribbean. The median age was 56 years (range 34–79 years). The mean preoperative IOP on maximum tolerated medical treatment was 22.4 mmHg (SD=5.9 mmHg). With or without medication, IOP was ≤21 mmHg in 92.6% at 1 year and 87.5% at 5 years. At 1 year, IOP was ≤18 mmHg in 78%, ≤15 mmHg in 73% and ≤14 mmHg in 52%. Removal of scleral flap releasable suture(s) was performed in 84%, 5-fluorouracil injection(s) in 88% and bleb needling revision in 38%. The most common complication was early transient bleb leak (52%). No patient developed endophthalmitis, hypotony maculopathy, suprachoroidal hemorrhage, or malignant glaucoma. At the final follow-up, 91% had excellent or satisfactory bleb morphology, and 73% had equal or better BCVA.ConclusionSkills transfer between different geographical and economic regions contributes to the prevention of avoidable blindness through disease control – one of the core strategies of the World Health Organization’s Vision 2020 initiative. In the Caribbean (Trinidad and Tobago), the MSSS was utilized by a surgeon with Glaucoma Fellowship training and achieved outcomes similar to best-published data. This success can be reproduced in other geographic locations.

show abstract

Trabeculectomy with Long-Term-Stored Mitomycin C in a West Indian Population

Cited by 5 publications

References 11 publications

Trabeculectomy with and without Mitomycin-C in a Black African Population

Trabeculectomy with and without Mitomycin-C in a Black African Population

Selective Laser Trabeculoplasty for the Management of Open-Angle Glaucoma in St. Lucia

ReGAE 12: preventing glaucoma blindness in the Caribbean through implementation of the Moorfields Safer Surgery System and skills transfer from the UK to Trinidad and Tobago

Contact Info

Product

Resources

About