Sharma Ashok K, Gupta Palak, Sharma Hans Raj
Department of Ophthalmology, Government Medical College, Jammu, Jammu and Kashmir, India.
Int J Appl Basic Med Res. 2021 Apr-Jun;11(2):80-84. doi: 10.4103/ijabmr.IJABMR_609_20. Epub 2021 Apr 8.
Glaucoma is a serious vision-threatening condition appropriately called as the silent killer of sight. The effect of postoperative fibrosis on success of filtration surgeries requires modulation of the wound healing process.
The aim of the study was to compare trabeculectomy augmented with collagen matrix implant with mitomycin C in primary glaucoma.
This prospective, longitudinal, hospital-based, analytical, and interventional study was conducted on 36 eyes of 36 patients. Group 1 included 18 patients who underwent trabeculectomy combined with subconjunctival collagen matrix implant and Group 2 included 18 patients who underwent trabeculectomy augmented with intraoperative mitomycin C (0.04 mg/ml) for 2 min. Each patient underwent detailed ocular examination and comparison was drawn by recording intraocular pressure (IOP), bleb characteristics, and postoperative complications.
The cumulative success rates at the end of our study were similar in two groups, 94.44% in Group 1 and 88.89% in Group 2 ( = 1.000). The mean reduction in IOP at 24 weeks in Group 1 was 18.67 ± 7.59 mmHg and in Group 2 was 21.32 ± 5.84 mmHg. The reduction in IOP was similar between the two groups ( = 0.290). The mean fall in IOP was 56.46% in Group 1 and 64.70% in Group 2 at 24 weeks. Mean bleb score in Group 1 was 10.33 ± 1.23 and in Group 2 was 8.89 ± 1.41, and the difference was statistically significant ( = 0.002). Shallow anterior chamber, overfiltration, and hypotony were statistically higher in Group 2 than in Group 1 ( = 0.041, 0.041, and 0.046, respectively).
Collagen matrix implant as an adjuvant to trabeculectomy is noble, safe, and effective option as compared to mitomycin C.
青光眼是一种严重威胁视力的疾病，被恰当地称为视力的无声杀手。术后纤维化对滤过性手术成功率的影响需要调节伤口愈合过程。
本研究的目的是比较在原发性青光眼中小梁切除术联合胶原基质植入物与丝裂霉素C的效果。
本前瞻性、纵向、基于医院的分析性和干预性研究对36例患者的36只眼进行。第1组包括18例行小梁切除术联合结膜下胶原基质植入物的患者，第2组包括18例行小梁切除术并术中使用丝裂霉素C（0.04 mg/ml）2分钟的患者。对每位患者进行详细的眼部检查，并通过记录眼压（IOP）、滤过泡特征和术后并发症进行比较。
在我们研究结束时，两组的累积成功率相似，第1组为94.44%，第2组为88.89%（P = 1.000）。第1组在24周时眼压的平均降低值为18.67±7.59 mmHg，第2组为21.32±5.84 mmHg。两组间眼压降低情况相似（P = 0.290）。在24周时，第1组眼压平均下降56.46%，第2组为64.70%。第1组的平均滤过泡评分为10.33±1.23，第2组为8.89±1.41，差异有统计学意义（P = 0.002）。第2组浅前房、滤过过度和低眼压在统计学上高于第1组（分别为P = 0.041、0.041和0.046）。
与丝裂霉素C相比，胶原基质植入物作为小梁切除术的辅助手段是一种良好、安全且有效的选择。
