Objective: to assess the clinical safety and the IOP lowering effect of the intraoperative use of MMC during non penetrating trabecular surgery.
Setting: Clinique Sourdille, Nantes, France
Material and methods: 56 consecutive eyes of 48 patients, suffering from uncontrolled open angle glaucoma, all previously operated and at high risk of surgical failure in case of reoperation. Average age was 67, 8 years. Average medication was 1,88 treatments.Surgical technique was similar in all cases: application of MMC 0,4 mg/ml with a microsponge placed under the superficial flap of the sclerectomy, in contact with the floor of the decompression chamber. Intraoperative complications consisted of 12 microperforations without iris prolapse. Examinations were done at day 1, 8-10, 1 month and every three months for the first year. Three patients (3 eyes) wer lost to followup after 6 months, all the other were followed by us. Average followup is 28 months (extremes:13m. - 45m.).
Results: IOP went down from an average preoperative of 25 mmhg under Treatment to an average post operative 13,8 mmhg
without treatment (extremes 6-22). Average treatment postop was 0, 58. Complications included 4 choroidal detachments, spontaneously resolutive in a maximum of one week, 6 positive Seidel phenomenons at the limbal incision (1 surgical repair). No corneal edema nor corneal decompensation occured.
Conclusions: In a consecutive sery of previously operated glaucomatous eyes MMC demonstrated clinical safety and efficacy on IOP lowering.