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

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.