Indian Journal of Public Health Research & Development

  • Year: 2014
  • Volume: 5
  • Issue: 4

To Compare the Intra Ocular Pressure Reduction between SICS and Trabeculectomy with and without the use of Intra Operative Mitomycin-C

1Assistant professor, Dept. of Ophthalmology, Navodaya Medical College and Research Hospital, Raichur, Karnataka

2Associate Professor, Dept. of Pathology, Navodaya Medical College and Research Hospital, Raichur, Karnataka

Abstract

To compare the Intra ocular pressure reduction between Small Incision Cataract Surgery and Trabeculectomy with and without the use of intra operative Mitomycin-C.

A Prospective Randomized study was performed on patients attending Ophthalmology OPD at Navodaya Medical College Hospital, Raichur between August 2009 to September 2011. A total of 42 eyes of 38 patients which included 20 males and 18 females in the age group of 40–65 years were divided into two groups. Group 1 included 21 eyes (with intra-operative MMC), Group 2 included 21 eyes (without intra-operative MMC). Patients with primary open angle glaucoma and senile cataract were included in the study. All patients were on anti-glaucoma medication of more than 2 months duration. Pre-operatively all patients underwent detailed ocular examination which included Visual Acuity, Perkins tonometry, Gonioscopy, Perimetry and Biometry. And post-operatively they were followed up on 1st day, 1st week, 1, 3, 6 months and last follow up was done at 1 year. Successful control of Intraocular pressure (IOP) was defined as achieving IOP less than 21 mmHg without medication.

No significant difference in age, sex, laterality, pre-operative IOP were noted between the two groups. Mean pre-operative Intra ocular pressure in group 1 (22.285±2.028) mmHg and in group 2 (21.8095±2.442) mmHg. Post-operatively mean Intra ocular pressure decreased to 14.095±2.406 mmHg in group 1 and in group 2 showed mean reduction of Intra ocular pressure of 17.333±3.367 mmHg after a period of 12 months follow up. Significant reduction in IOP was noted in both the groups (p <0.0001). Group 1 showed greater reduction in IOP (p =0.0009) and better stability as compared to Group 2. 18 eyes (85.71%) of group 1 showed best corrected visual acuity ? 6/12. 19 eyes (90.4%) in group 2 showed best corrected visual acuity ? 6/12. No significant difference in postoperative complication was noted expect for the Encapsulated Bleb.

Use of intra-operative Mitomycin-C in combined small incision cataract surgery and trabaculectomy showed a greater reduction of intra ocular pressure and better stability after 1 year of follow up.

Keywords

Small Incision Cataract Surgery (SICS), Trabeculectomy, Mitomycin-C (MMC)