A comparative study of small Incision trabeculectomy avoiding tenon′s capsule vis-à-vis trabeculectomy with mitomycin-C

Abstract

Purpose: To compare the results of small incision trabeculectomy avoiding Tenon′s capsule (SIT) vis-à-vis intraoperative use of Mitomycin-C (MMC) in primary chronic angle closure glaucoma. Methods: A controlled prospective study was conducted on 60 consecutive primary chronic angle closure glaucoma patients requiring glaucoma filtration surgery. Patients were divided into two groups, Group I (n=30): those undergoing SIT and Group II (n=30): those undergoing trabeculectomy with MMC. Patients were followed up serially for 24 months and their intraocular pressure (IOP) was monitored. Success was defined as IOP - 22 mm Hg with no additional anti-glaucoma medication or laser/surgical intervention. Success was also defined as a 30% reduction from the initial IOP at which optic disc cupping and/or visual field changes occurred. Results: The final mean IOP with SIT was 16.80±4.20 mm Hg as against 17.84±3.80 mm Hg with trabeculectomy with MMC. Final success rate of 93.3% was obtained with SIT versus 90% with trabeculectomy with MMC. No major complications were seen with either procedure. Conclusion: Small incision trabeculectomy safely and effectively reduces the IOP in over 90% cases. The advantages of this procedure over trabeculectomy with MMC are its low cost, use of a small (2.5 mm) limbal incision which obviates the dissection of Tenon′s capsule and absence of any major complication.

Keywords

• Small incision trabeculectomy
• trabeculectomy
• mitomycin-C
• chronic angle closure glaucoma