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KMID : 0213520230370030216
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Korean Journal of Ophthalmology
2023 Volume.37 No. 3 p.216 ~ p.223
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Effect of Intraoperative Mitomycin C on the Surgical Outcomes of Ahmed Glaucoma Valve Implantation with Ciliary Sulcus Tube Placement
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Kim Na-Eun
Kim Sung-Sik
Lee Ji-Hei Sara
Lee Kwang-Hyun
Bae Hyoung-Won
Lee Sang-Yeop
Choi Wung-Rak
Kim Chan-Yun
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Abstract
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Purpose: To evaluate the effect of intraoperative mitomycin C (MMC) on the surgical outcomes of ciliary sulcus (CS) Ahmedglaucoma valve (AGV) tube placement.
Methods: A retrospective review of medical records of 54 consecutive patients who underwent AGV implantation with tubeplaced in CS was performed. Consecutive cases operated without the use of intraoperative MMC from 2017 to 2019 werecompared with consecutive cases operated with MMC from 2019 to 2021. Surgical failure was defined as intraocular pressure(IOP) exceeding 21 mmHg in two consecutive visits after postoperative 3 months or ≤30% IOP reduction, IOP ≤5 mmHg intwo consecutive visits, or loss of light perception. Kaplan-Meier survival analysis and log-rank test were performed to comparethe surgical failure rates.
Results: A total of 54 eyes of 54 patients were investigated. Mean follow-up period after AGV implantation was 1.4 ± 0.8years. The MMC group showed significantly lower IOP during the 1st postoperative month (20.5 ± 8.6 mmHg vs. 15.8 ± 6.4mmHg, p = 0.027), but the difference did not persist 6 months after the surgery (p = 0.805). The mean number of postoperativeantiglaucoma medications was significantly lower in the MMC group in the 1st postoperative month (p = 0.047) butno difference was found at 6 months. No statistical difference was noted in the rates of postoperative complications. Kaplan-Meier survival analysis showed comparable survival rates between MMC group and no MMC group (p = 0.356).
Conclusions: The intraoperative use of MMC significantly lowered IOP in the 1st postoperative month but did not increase 6months success rates in patients receiving AGV tube placement in CS.
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KEYWORD
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Ahmed glaucoma valve, Ciliary sulcus, Glaucoma, Glaucoma drainage implants, Intraocular pressure
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