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Klin Monbl Augenheilkd ; 231(10): 1012-5, 2014 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-25333240

RESUMEN

BACKGROUND: The covered sclerotomy is a minimally invasive, standardized fistulating glaucoma surgical procedure with reduced risk of complications. Early postoperative bleb fibrosis is a main success-limiting problem. In this clinical study IOP follow-up and the one year success rate after primary application of mitomycin C (MMC) is analyzed. PATIENTS AND METHODS: In 76 eyes with advanced glaucoma and without previous fistulating surgery, a covered sclerotomy combined with 3-minute-application of MMC0,02 % was performed. Over a period of 12 months, bleb and pressure were controlled regularly. The success rates were compared primarily with data from an earlier study without application of MMC. RESULTS: The mean age of the patients was 70 ± 11 years. 45 % had a pseudoexfoliation syndrome while 41 % were pseudophakic. The mean intraocular pressure (IOP) was 27 ± 8,5 mmHg preoperatively. After 12 months it was 16,2 ± 4,3 mmHg (p < 0.05) with a mean IOP reduction of 40 %. The absolute success rate (intraocular pressure < 21 mmHg without antiglaucoma therapy) was 58 % and the relative success rate (intraocular pressure < 21 mmHg under treatment) was 71 %. A revision or a needling was performed in 22 eyes (29 %). MMC-related complications were not observed. CONCLUSION: Through the additional MMC application on the base of the primary covered sclerotomy a significant pressure reduction could be achieved. 58 % of the patients didn't need any glaucoma medicine. The absolute success rate was higher than without additional inhibitions of the fibrosis.


Asunto(s)
Extracción de Catarata/efectos adversos , Procedimientos Quirúrgicos Mínimamente Invasivos/efectos adversos , Mitomicina/administración & dosificación , Premedicación/métodos , Enfermedades de la Esclerótica/etiología , Enfermedades de la Esclerótica/prevención & control , Esclerostomía/efectos adversos , Anciano , Extracción de Catarata/métodos , Femenino , Humanos , Masculino , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Esclerostomía/métodos , Resultado del Tratamiento
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