| Past Issue | Volume 7, Number 3, 2005 | | Comparison of Subscleral Partial Thickness Sclerectomy plus Trabeculotomy with Trabeculectomy for Primary Open Angle Glaucoma |
Harish C Agarwal, P Elankumaran, Viney Gupta, Jeevan S Titiyal
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India
Aim: To compare the success rate and complications of subscleral partial thickness sclerectomy plus trabeculotomy with those of trabeculectomy alone for primary open angle glaucoma.
Patients and Methods: Sixty seven eyes of 67 patients with primary open angle glaucoma were enrolled in this randomised controlled trial. Thirty four eyes of 34 patients underwent subscleral partial thickness sclerectomy plus trabeculotomy with mitomycin C and 33 eyes of 33 patients underwent modified Cairn's trabeculectomy with mitomycin C. A complete ophthalmic examination was performed before surgery and on postoperative days 1, 3, 5, and 7, and after 2, 3, and 4 weeks, and 3, 6, 12, 18, and 24 months.
Results: The cumulative probability of complete success (intraocular pressure <21 mm Hg without medication) after 2 years, using Kaplan-Meier survival analysis, was 76% in the eyes that underwent trabeculectomy alone compared with 52% in the eyes that underwent subscleral partial thickness sclerectomy plus trabeculotomy (log-rank test, p = 0.07). Two eyes in the trabeculectomy-alone group had flat anterior chambers with corneolenticular touch and required anterior chamber reformation. Hyphaema and development and progression of cataract were observed more frequently in patients receiving trabeculectomy than in those receiving subscleral partial thickness sclerectomy with trabeculotomy.
Conclusions: Subscleral partial thickness sclerectomy plus trabeculotomy with mitomycin C offers an alternative to standard trabeculectomy with mitomycin C.
Key Words: Glaucoma, open angle, Trabeculectomy
Asian J Ophthalmol 2005;7(3):96-100.
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