Deep Sclerectomy with Mitomycin C - A Comparative Study in West Africa
Mielke C., Dawda V. K., Anand N. M.
Eye Hospital Lagos, Nigeria
Purpose: To prospectively study and compare the effectiveness and the safety of primary deep sclerectomy with and without the use of Mitomycin C in eyes with open‑angle glaucoma in West African patients in Lagos, Nigeria.
Method: 42 eyes of 42 patients with primary open‑angle glaucoma were enrolled consecutively and assigned randomly to undergo deep sclerectomy without the use of Mitomycin C (DS group) and deep sclerectomy with the application of Mitomycin C (DS‑MMC group). Mitomycin C 0.25 mg/ml was applied for 1 minute at the end of the procedure, before conjunctival flap closure. 5 eyes were excluded because of intraoperative perforation of the trabeculo‑descemet's membrane.
Results: There were 16 eyes in the DS group and 21 eyes in the DS‑MMC group. The preoperative I0Ps were higher in the DS group but the difference was not statistically significant (MANOVA, p=0.09). The probability of maintaining an IOP less than 18 mm Hg at one year was 71 % in the DS‑MMC and 34 % in the DS group, but this difference was not significant by the log‑rank test (p=0.22). However the probability of maintaining an lOP below 14 mm Hg at one year was significantly higher in the DS‑MMC group (69%) as compared to the DS group (0 %, p=0.02). A Cox's regression analysis model showed no effect of age, sex, surgeon or preoperative lOP on the success of deep sclerectomy. Revision of the procedure with antimet
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