A comparative study of small Incision trabeculectomy avoiding tenon′s capsule vis-à-vis trabeculectomy with mitomycin-C

• Main Authors: Das Jaychandra, Sharma Pankaj, Chaudhuri Zia
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2004-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Small incision trabeculectomy; trabeculectomy; mitomycin-C; chronic angle closure glaucoma
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2004;volume=52;issue=1;spage=23;epage=28;aulast=Das

<b>Purpose: </b> To compare the results of small incision trabeculectomy avoiding Tenon&#x2032;s capsule (SIT) vis-&#x00E0;-vis intraoperative use of Mitomycin-C (MMC) in primary chronic angle closure glaucoma. <b> Methods:</b> A controlled prospective study was conducted on 60 consecutive primary chronic angle closure glaucoma patients requiring glaucoma filtration surgery. Patients were divided into two groups, Group I (n=30): those undergoing SIT and Group II (n=30): those undergoing trabeculectomy with MMC. Patients were followed up serially for 24 months and their intraocular pressure (IOP) was monitored. Success was defined as IOP - 22 mm Hg with no additional anti-glaucoma medication or laser/surgical intervention. Success was also defined as a 30&#x0025; reduction from the initial IOP at which optic disc cupping and/or visual field changes occurred. <b> Results: </b> The final mean IOP with SIT was 16.80&#x00B1;4.20 mm Hg as against 17.84&#x00B1;3.80 mm Hg with trabeculectomy with MMC. Final success rate of 93.3&#x0025; was obtained with SIT versus 90&#x0025; with trabeculectomy with MMC. No major complications were seen with either procedure. <b> Conclusion:</b> Small incision trabeculectomy safely and effectively reduces the IOP in over 90&#x0025; cases. The advantages of this procedure over trabeculectomy with MMC are its low cost, use of a small (2.5 mm) limbal incision which obviates the dissection of Tenon&#x2032;s capsule and absence of any major complication.