Our results of large area mitomycin C application trabeculectomy in cases with advanced glaucoma

Yıl 2013, Cilt: 40 Sayı: 4, 597 - 600, 01.12.2013

Mutlu Cihan Dağlıoğlu Esra Ayhan Tuzcu Nilüfer İlhan Mesut Coşkun Emre Ayıntap Uğurcan Keskin Özgür İlhan Hilal Kahraman

https://doi.org/10.5798/diclemedj.0921.2013.04.0339

Öz

Objective: To evaluate large area Mitomycin-C (MMC) applied trabeculectomy results in advanced glaucoma patients in which targeted intraocular pressure (IOP) can not be achieved with maximum medical therapy. Methods: 41 eyes of 35 advanced glaucoma patients that can not be controlled with medical treatment were included to the study. Large area MMC application was applied for 2 minutes in 0.2 mg/ml concentration. The mean follow-up period was 28 months (24-36). All of the cases were advanced glaucoma patients and 21mmHg IOP level could not be achieved in spite of maximum treatment with three drugs. Results: Of the 35 patients that were included to study, 19 were male and 16 were female and the mean age was 52.5±1.8 years (range, 45-73). Twenty-seven of eyes were primary open angle glaucoma, 11 was pseudoexfoliative glaucoma, 3 were angle closure glaucoma. In 5 eyes (12.1%) there were early hypotonia. Additional suturation was made in 2 eyes with hypotonia. Two eyes were treated with tight patching. Suture addition was made in 1 eye with choroid effusion. Cataract was developed in 4 eyes. There were 3 cystic bleb (7.3%) and they were treated with needle application. Thin avascular bleb was developed in 10 eyes (24.4%). In other eyes (68.3%) there were thin diffuse bleb formations. When targeted IOP was considered as 15 mmHg, targeted IOP was achieved in 36 (87.8%) eyes. Conclusion: We suggest that trabeculectomy with large area MMC application is an effective choice in advanced glaucoma patients in which targeted IOP can not be achieved with maximum medical treatment.

Anahtar Kelimeler

Mitomycin-C, trabeculectomy, bleb

İleri evre glokomlu olgularda geniş alan mitomisin C uygulamalı trabekülektomi sonuçlarımız

Öz

Amaç: Maksimum tıbbi tedavi ile hedef göziçi basıncı (GİB) sağlanamayan ileri evre glokomlu hastalarda geniş alan Mitomisin-C (MMC) uygulamalı trabekülektomi sonuçlarının değerlendirilmesi amaçlandı. Yöntemler: Çalışmaya medikal tedavi ile kontrol altına alınamayan ileri evre glokomu olan 35 hastanın 41 gözü dahil edilmiştir. Geniş alan MMC uygulaması 0,2 mg/ml konsantrasyonda 2 dk süre ile uygulanmıştır. Ortalama izlem süresi 28 aydır (24-36). Olguların hepsi maksimum 3\'lü tedaviye rağmen GİB 21 mmHg altına düşmeyen ileri derecede glokomu olan hastalardır. Bulgular: Çalışmaya dahil edilen 35 hastanın 19\'u erkek 16\'sı kadın idi ve yaş ortalaması 52,5±1,8 yıl (45-73) olarak bulundu. Opere edilen gözlerin 27\'si primer açık açılı glokom, 11\'i psödoeksfolyatif glokom, 3\'ü açı kapanması glokomu idi. 5 (%12,1) gözde erken dönem hipotoni gelişmiştir. Hipotoni gelişen 2 göze ek sütür konulmuştur. İki göz sıkı bandaj kapama ile tedavi edilmiştir. Koroid effüzyonu gelişen 1 göze ek operasyonla sütür eklenmiştir. Dört gözde katarakt gelişmiştir. 3 gözde kistik bleb (%7,3) görülmüş iğneleme ile tedavi edilmiştir. On gözde (%24,4) ince avasküler bleb gelişmiştir. Diğer gözlerde (%68,3) ince diffüz ve fonksiyonel bleb izlenmiştir. Hedeflenen GİB 15mmHg olarak değerlendirildiğinde gözlerin 36\'sında (%87,8) hedeflenen GİB değerine ulaşılmıştır Sonuç: Maksimum tıbbi tedavi ile hedef GİB sağlanamayan ileri evre glokomlu hastalarda, geniş alan MMC uygulamalı trabekülektomi yönteminin etkili bir seçenek olabileceği düşünüldü.

Anahtar Kelimeler

Mitomisin-C, trabekülektomi, bleb

Kaynakça

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