Department of Ophthalmology, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1St Road, Zuoying District, Kaohsiung City, 81362, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.
Int Ophthalmol. 2023 Aug;43(8):2593-2603. doi: 10.1007/s10792-023-02658-6. Epub 2023 Mar 10.
Mitomycin C (MMC) is normally used to avoid scar formation in trabeculectomy. There has been a shift from conventional delivery via soaked sponges to preoperative injection of MMC. This study aimed to compare the effectiveness of a modified two-stage low-dose intra-Tenon injection with soaked sponges of MMC for trabeculectomy over a 1-year follow-up period.
This retrospective study enrolled patients with glaucoma undergoing modified trabeculectomy with a two-stage intra-Tenon injection (0.01%, 0.1 mL) or soaked sponges (0.02%) of MMC. In the former group, patients received intra-Tenon injection of MMC (the first stage) at least 4 h before trabeculectomy (the second stage). Patient characteristics, preoperative and postoperative intraocular pressure, antiglaucoma medication use, complications, and post-trabeculectomy surgical interventions were recorded during a 1-year follow-up period.
There were 36 and 35 eyes in the injection and sponge groups, respectively, in 58 patients. The injection group showed significantly lower intraocular pressure (p < 0.05) at every time point except on postoperative day 1 and week 1, fewer medications at the 1-year follow-up (p = 0.018), and a higher complete success rate (p = 0.011) than the sponge group. Both techniques showed a significant reduction in intraocular pressure and medication use at the 1-year follow-up. There were no significant differences in complications between both groups.
Our two-stage intra-Tenon MMC injection technique resulted in lower postoperative intraocular pressure, less antiglaucoma medication use, and fewer needling revisions compared to the sponge technique.
丝裂霉素 C（MMC）通常用于避免小梁切除术形成瘢痕。目前，MMC 的给药方式已经从传统的浸泡海绵转变为术前注射。本研究旨在比较改良两阶段低剂量经 Tenon 注射与 MMC 浸泡海绵在 1 年随访期内对小梁切除术的疗效。
本回顾性研究纳入了接受改良两阶段经 Tenon 注射（0.01%，0.1ml）或 MMC 浸泡海绵（0.02%）的青光眼患者。在前一组中，患者在小梁切除术（第二期）前至少 4 小时接受经 Tenon 注射 MMC（第一期）。在 1 年随访期间，记录了患者特征、术前和术后眼压、抗青光眼药物使用、并发症和小梁切除术后手术干预情况。
58 例患者中，注射组和海绵组分别有 36 只和 35 只眼。注射组除术后第 1 天和第 1 周外，各时间点眼压均显著降低（p<0.05），1 年随访时用药更少（p=0.018），完全成功率更高（p=0.011）。两种方法在 1 年随访时眼压和药物使用均显著降低。两组间并发症无显著差异。
与海绵技术相比，我们的两阶段经 Tenon 注射 MMC 技术可降低术后眼压、减少抗青光眼药物使用和减少针刺修订次数。
