To Compare the Effect on IOP Following Primary Trabeculectomy with MMC 0.2% versus Trabeculectomy without MMC in Primary Open Angle Glaucoma
Zakaullah Gopang
Department of Ophthalmology, Chandka Medical College and Hospital, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan.
Shabeer Ahmed Bhutto *
Department of Ophthalmology, Chandka Medical College and Hospital, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan.
Naeem Akhtar Katpar
Department of Ophthalmology, Chandka Medical College and Hospital, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan.
Arslan hassan Rajper
Department of Ophthalmology, Indus Medical College Tando Muhammad Khan, Pakistan.
Vijay Nagdev
Department of Ophthalmology, Chandka Medical College and Hospital, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan.
*Author to whom correspondence should be addressed.
Abstract
Objective: To determine the effect on intraocular pressure following primary Trabeculectomy with MMC 0.2% versus Trabeculectomy without MMC in Primary Open Angle Glaucoma.
Study Design: This is a prospective and experimental Study.
Setting: Study carried out at Ophthalmology Department, Shaheed Mohtarma Benazir Bhutto Medical University Larkana, from 01-03-2020 to 31-08-2020 (06 Months).
Materials and Methods: The patients with primary open angle glaucoma were selected from glaucoma clinic after taking careful history and clinical examination. Patients selected for trabeculectomy into two groups. Group A includes 43 patients while Group B also includes 43 patients. Among Group A patients adjunctive MMC 0.2mg/ml for a period of 3 minutes was used during trabeculectomy as a primary procedure (Test Group) while Group B patients were operated without MMC 0.2% (Control Group). Follow-up period of 06 months was observed in both groups. The span of study was from 01-03-2020 to 31-08-2020.
Results: The total of 86 Eyes of 86 patients of POAG were included in this study. Group A patients were operated for trabeculectomy with MMC while group B patients were operated for trabeculectomy without MMC. The mean IOP before surgery of Group-A was 25.39±2.42 mmHg while in Group-B it was 26.23±4.23mmHg. At day 1 of surgery in Group-A patients IOP was 13.20±3.05 mmHg while in Group-B patients IOP, was 14.09±4.04 mmHg. After 3 months in Group-A, IOP was 13.04±3.81 mmHg in Group-B IOP was 14.01±4.18 mmHg. Out of 43 patients in Group-A, 41(95.3%) were succeeded while in Group-B, 39(90.7%)were succeeded. Significant result was found for IOP reduction after 6 months of surgeryin group-A IOP was 13.48 + 2.86 mmHg while in group-B, IOP was 15.09 ±2.64 (P=0.754).
Conclusion: Trabeculectomy with MMC as a primary procedure seems to be more effective than trabeculectomy without MMC.
Keywords: IOP, primary trabeculectomy, MMC, POAG