Neovasküler glokomlu olgularda mitomisin-C ile trabekülektomi

Özet

Amaç: Neovasküler glokomlu (NVG) olgularda mitomisin C (MMC) ile trabekülektominin etkinligini belirlemek. Gereç ve Yöntem: MMC ile trabekülektomi yapilan NVG'lu 18 olgunun 18 gözü prospektif olarak incelendi. Bulgular: NVG'un nedeni 13 olguda proliferatif diabetik retinopati, 5 olguda sanral retinal ven tikanikligi idi. Tüm olgulara 0.2 mg/ml MMC ile trabekülektomi operasyonu yapildi. Olgularin operasyon öncesi ortalama göz içi basinci (GIB) 51.38±4.59 (45-58) mmHg iken, operasyon sonrasi ortalama GIB'leri 1.gün 10.69±5.15 mmHg, 1.hafta 13.84±4.54 mmHg, 1.ay 16.07±5.99 mmHg, 3.ay 16.76±6.83 mmHg, 6.ay 17.76±7.95 mmHg ve son kontrolde 17.46±8.23 mmHg olarak saptandi. Operasyon sonrasi son kontrolde 13 (%72) olguda tek cerrahi girisimle 21 mmHg ve altinda GIB elde edildi. Alti olguda (%35) hifema, 5 olguda (%28) ön kamara sigligi, 5 olguda (%28) geçici oküler hipotoni gelisti. Bes olguya (%28) ikinci bir filtrasyon cerrahisi uygulandi. Iki olguda (%12) ikinci bir filtran cerrahi sonrasinda 21 mmHg altinda GIB elde edildi. Üç olguda (%17) ikinci filtrasyon cerrahisinde de basarisiz olundu. Bir olguya evisserasyon uygulandi. Iki olguya (%12) siklokrioterapi uygulandi. Bir olguda fitizis bulbi gelisti, 1 olguda isik persepsiyonun kaybolmasi ve agri nedeni ile evisserasyon uygulandi. Sonuç: NVG'lu olgularda MMC ile trabekülektomi, erken dönem basari orani yüksek bir cerrahi yöntemdir.

Abstract

Purpose: To determine the effectiveness of trabeculectomy with mityomycin-C (MMC) in neovascular glaucoma (NVG) patients. Material and Methods: Eighteen eyes of 18 NVG patients who underwent trabeculectomy with MMC were assessed prospectively. Results: NVG was due to proliferating diabetic retinopathy in 13 patients, and central retinal vein occlusion in 5 patients. Trabeculectomy with 0.2 mg/ml MMC was performed in all patients. While mean intraocular pressure (IOP) of the patients was 51.38±4.59 (45-58) mmHg preoperatively, it was 10.69±5.15 mmHg at the first day, 13.84±4.54 mmHg at the first week, 16.07±5.99 mmHg at the first month, 16.76±6.83 mmHg at the third month, 17.76±7.95 mmHg at the sixth month postoperatively and it was 17.46±8.23 mmHg at the last visit. At the last examination 21 mmHg and lower IOPs were obtained in 13 (72%) patients. Six patients (35%) developed hyphema, 5 patients (28%) developed anterior chamber shallowness and 5 patients (28%) developed temporary ocular hypotonia. A second filtration surgery was performed in 5 patients (28%). In 2 patients (12%), IOP lower than 21 mmHg was obtained after second filtering surgery. The second filtering surgery failed in 3 patients (17%). One patient underwent evisceration and 2 patients (12%) underwent cyclocryotherapy. One patient developed phthisis bulbi and the other one underwent evisceration because of pain and loss of light perception. Conclusion: Trabeculectomy with MMC in NVG patients is a method with a high success rate at the early postoperative period.