Purpose: To assess the intraocular pressure control and postoperative
complications of deep sclerectomy with the adjunctive use of mitomycin C.
Methods: In this prospective study 72 eyes of 60 consecutive patients
with medically uncontrolled primary open angle glaucoma underwent deep
sclerectomy with the adjunctive use of mitomycin-C by a single surgeon.
Glaucoma surgery was indicated if IOP was 22 or over in several measurements
with two or more topical agents.
Results: Mean follow up period was 17.2±6.2 months. The mean preoperative
IOP was 27±5.4 mmHg and the mean postoperative IOP was 12.4±2.5 at 1 day, and
16.4±3.8 at the last recorded examination. There were a significant reduction
of topical treatment from 2.5±0.6 medications preoperatively to 0.5±0.8 at the
last recorded examination. The Kaplan Meier probability of success
(IOP<21mmHg without treatment) was 55.5% at 24 months. Qualified success
rate, (IOP<21mmHg with less medication), was 80.5% at 24 months. Early
complications were flattening of the anterior chamber in 3 cases (4.2%),
choroidal detachment in 2 cases (2.8%), and hyphaema in 4 cases (5.5 %).
Progressive scaring of the filtering bleb was observed in 19.4% of patients.
Conclusion: Deep sclerectomy with mitomycin-C is an attractive
alternative to trabeculectomy in the treatment of POAG, with few postoperative
complications. Intraoperative use of mitomycin-C is an effective way to lower
the risk of scleral fibrosis.