Evaluation of the efficacy and safety of injectable cross-linked hyaluronic acid compared with mitomycin C in trabeculectomy surgery

Background Trabeculectomy has been a gold standard for the treatment of glaucoma for years since its introduction to ophthalmology literature, and the outcome depends mostly on the resulting intraocular pressure (IOP). However, the most common reason for trabeculectomy failure is the development of...

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Main Authors: Mahmoud H Mohamed, Mohamed A Abdelshafik, Hany M El Ibiary, Thanaa H Mohammed
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2015-01-01
Series:Journal of the Egyptian Ophthalmological Society
Subjects:
Online Access:http://www.jeos.eg.net/article.asp?issn=2090-0686;year=2015;volume=108;issue=4;spage=173;epage=179;aulast=Mohamed
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spelling doaj-fcd8fb00a0544189958756e2f57eb72a2020-11-24T22:27:23ZengWolters Kluwer Medknow PublicationsJournal of the Egyptian Ophthalmological Society2090-06862314-66482015-01-01108417317910.4103/2090-0686.174654Evaluation of the efficacy and safety of injectable cross-linked hyaluronic acid compared with mitomycin C in trabeculectomy surgeryMahmoud H MohamedMohamed A AbdelshafikHany M El IbiaryThanaa H MohammedBackground Trabeculectomy has been a gold standard for the treatment of glaucoma for years since its introduction to ophthalmology literature, and the outcome depends mostly on the resulting intraocular pressure (IOP). However, the most common reason for trabeculectomy failure is the development of fibrosis in the conjunctiva and episclera. Thus, glaucoma surgeons are still searching for an optimal substance for the modulation of wound-healing processes. Aim This study was conducted to evaluate the efficacy and safety of injection of cross-linked hyaluronic acid below the scleral flap and under the conjunctiva in trabeculectomy surgery compared with trabeculectomy with mitomycin C (MMC). Patients and methods A total of 24 eyes with primary open-angle glaucoma were included in this study. Patients were divided into two groups: group 1 included 12 eyes that underwent a standardized trabeculectomy surgery supplemented by the injection of cross-linked hyaluronic acid (HealaFlow) below the scleral flap and under the conjunctiva, and group 2 included 12 eyes that underwent a standardized trabeculectomy surgery with the application of MMC. The endpoints for comparison were IOP, success rates, and postoperative complications. Results The results of both groups were comparable, with no statistically significant difference between the two groups as regards IOP, success rates, and postoperative complications. Conclusion Cross-linked sodium hyaluronate (HealaFlow) injectable implant is comparable to MMC for trabeculectomy in terms of IOP-lowering efficacy, success rates, early and mid-term postoperative complications, and tolerability. However, the results should be interpreted cautiously as relevant evidence is still limited, although it is accumulating. Further large-scale, long-term, and well-designed randomized controlled trials are needed.http://www.jeos.eg.net/article.asp?issn=2090-0686;year=2015;volume=108;issue=4;spage=173;epage=179;aulast=MohamedHealaFlowintraocular pressuremitomycin CGlaucomatrabeculectomy
collection DOAJ
language English
format Article
sources DOAJ
author Mahmoud H Mohamed
Mohamed A Abdelshafik
Hany M El Ibiary
Thanaa H Mohammed
spellingShingle Mahmoud H Mohamed
Mohamed A Abdelshafik
Hany M El Ibiary
Thanaa H Mohammed
Evaluation of the efficacy and safety of injectable cross-linked hyaluronic acid compared with mitomycin C in trabeculectomy surgery
Journal of the Egyptian Ophthalmological Society
HealaFlow
intraocular pressure
mitomycin C
Glaucoma
trabeculectomy
author_facet Mahmoud H Mohamed
Mohamed A Abdelshafik
Hany M El Ibiary
Thanaa H Mohammed
author_sort Mahmoud H Mohamed
title Evaluation of the efficacy and safety of injectable cross-linked hyaluronic acid compared with mitomycin C in trabeculectomy surgery
title_short Evaluation of the efficacy and safety of injectable cross-linked hyaluronic acid compared with mitomycin C in trabeculectomy surgery
title_full Evaluation of the efficacy and safety of injectable cross-linked hyaluronic acid compared with mitomycin C in trabeculectomy surgery
title_fullStr Evaluation of the efficacy and safety of injectable cross-linked hyaluronic acid compared with mitomycin C in trabeculectomy surgery
title_full_unstemmed Evaluation of the efficacy and safety of injectable cross-linked hyaluronic acid compared with mitomycin C in trabeculectomy surgery
title_sort evaluation of the efficacy and safety of injectable cross-linked hyaluronic acid compared with mitomycin c in trabeculectomy surgery
publisher Wolters Kluwer Medknow Publications
series Journal of the Egyptian Ophthalmological Society
issn 2090-0686
2314-6648
publishDate 2015-01-01
description Background Trabeculectomy has been a gold standard for the treatment of glaucoma for years since its introduction to ophthalmology literature, and the outcome depends mostly on the resulting intraocular pressure (IOP). However, the most common reason for trabeculectomy failure is the development of fibrosis in the conjunctiva and episclera. Thus, glaucoma surgeons are still searching for an optimal substance for the modulation of wound-healing processes. Aim This study was conducted to evaluate the efficacy and safety of injection of cross-linked hyaluronic acid below the scleral flap and under the conjunctiva in trabeculectomy surgery compared with trabeculectomy with mitomycin C (MMC). Patients and methods A total of 24 eyes with primary open-angle glaucoma were included in this study. Patients were divided into two groups: group 1 included 12 eyes that underwent a standardized trabeculectomy surgery supplemented by the injection of cross-linked hyaluronic acid (HealaFlow) below the scleral flap and under the conjunctiva, and group 2 included 12 eyes that underwent a standardized trabeculectomy surgery with the application of MMC. The endpoints for comparison were IOP, success rates, and postoperative complications. Results The results of both groups were comparable, with no statistically significant difference between the two groups as regards IOP, success rates, and postoperative complications. Conclusion Cross-linked sodium hyaluronate (HealaFlow) injectable implant is comparable to MMC for trabeculectomy in terms of IOP-lowering efficacy, success rates, early and mid-term postoperative complications, and tolerability. However, the results should be interpreted cautiously as relevant evidence is still limited, although it is accumulating. Further large-scale, long-term, and well-designed randomized controlled trials are needed.
topic HealaFlow
intraocular pressure
mitomycin C
Glaucoma
trabeculectomy
url http://www.jeos.eg.net/article.asp?issn=2090-0686;year=2015;volume=108;issue=4;spage=173;epage=179;aulast=Mohamed
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