Penetran keratoplasti sonrası glokomda mitomisin-C'li ve mitomisin-C'siz trabekülektomi

Özet

Amaç: Keratoplasti sonrası gelişen glokomda mitomisin C'li ve mitomisin C'siz yapılan trabekülektominin etkinliğini karşılaştırmak Yöntem: Retrospektif olarak, penetran keratoplasti (PK) sonrası medikal tedaviyle kontrol edilemeyen ve trabekülektomi yapılan glokomlu olgular incelendi. Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi 1. Göz Kliniğinde Ocak 1993-Eylül 2000 tarihleri arasında PK yapılan 39 olgunun 45 gözü çalışma kapsamına alındı. 29 göze mitomisin C'li 16 göze ise mitomisin C'siz trabekülektomi yapıldı. Ortalama takip süresi 22,8 aydı (3-31 ay). Mitomisin C'li ve Mitomisin C'siz yapılan trabekülektomilerin ameliyat sonrası başarı oranı ve komplikasyonları karşılaştırıldı. Bulgular: Mitomisin C'li trabekülektomi yapılan 20 (%68,9) göz ve Mitomisin C'siz trabekülektomi yapılan 4 göz (%25)'de sonuçlar başarılıydı (Göz içi basınç (GİB)

Abstract

Trabeculectomy With and Without Mitomycin C in Post Keratoplasy Glaucoma Purpose: To investigate the effect of trabeculectomy with and without mitomycin C in post-keratoplasty glaucoma.Methods: A retrospective study was performed on patients who underwent trabeculectomy for uncontrolled glaucoma with medical therapy after penetrating keratoplasty (PK). Forty-five eyes of 39 patients who had undergone PK between January 1993 and September 2000 in Dr. Lütfi Kırdar Kartal Training and Research Hospital were included in this study. Trabeculectomy with mitomycin C was performed in 29 eyes and without mitomycin C in 16 eyes. The mean follow-up period was 22.8 months (range 3 to 31 months). Postoperative success rate and complications of trabeculectomy with mitomycin C and without mitomycin C were compared. Results: Trabeculectomy was successful (TOP < 21-mmHg) in 20 eyes (68.9%) with mitomycin C and in four eyes (25%) without mitomycin C. In the group who underwent trabeculectomy with mitomycin C, nine (31.03%) had graft decompansation, three (10,34%) had epithelial defects, one (3,44%) had choroidal detachment and three (10,34%) had bleb leakage. In the group who underwent trabeculectomy without mitomycin C, seven (43,75%) eyes had graft failure, two (12,5%) had epithelial defects, one (6,25%) had choroidal detachment and two (12,5%) had bleb leakage. Final graft clarity rate was 65.52% (19/29) in the group with mitomycin C and 31.25% (5/16) in the group without mitomycin C. Conclusion: We concluded that intraocular pressure is better controlled by trabeculectomy with mitomycin C than without mitomycin C in post-keratoplasty glaucoma. As well as, because theirs complications of both methods were almost the same, trabeculectomy with mitomycin C is more favorable in glaucoma after PK.