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Effect of Intraoperative Mitomycin C on the Surgical Outcomes of Ahmed Glaucoma Valve Implantation with Ciliary Sulcus Tube Placement

 Na Eun Kim  ;  Sung Sik Kim  ;  Jihei Sara Lee  ;  Kwanghyun Lee  ;  Hyoung Won Bae  ;  Sang Yeop Lee  ;  Wungrak Choi  ;  Chan Yun Kim 
 Korean Journal of Ophthalmology, Vol.37(3) : 216-223, 2023-06 
Journal Title
Korean Journal of Ophthalmology
Issue Date
Eye ; Glaucoma* ; Humans ; Intraocular Pressure ; Mitomycin ; Ocular Hypotension* ; Treatment Outcome
Ahmed glaucoma valve ; Ciliary sulcus ; Glaucoma ; Glaucoma drainage implants ; Intraocular pressure
Purpose: To evaluate the effect of intraoperative mitomycin C (MMC) on the surgical outcomes of ciliary sulcus (CS) Ahmed glaucoma valve (AGV) tube placement.

Methods: A retrospective review of medical records of 54 consecutive patients who underwent AGV implantation with tube placed in CS was performed. Consecutive cases operated without the use of intraoperative MMC from 2017 to 2019 were compared 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 in two consecutive visits, or loss of light perception. Kaplan-Meier survival analysis and log-rank test were performed to compare the surgical failure rates.

Results: A total of 54 eyes of 54 patients were investigated. Mean follow-up period after AGV implantation was 1.4 ± 0.8 years. The MMC group showed significantly lower IOP during the 1st postoperative month (20.5 ± 8.6 mmHg vs. 15.8 ± 6.4 mmHg, p = 0.027), but the difference did not persist 6 months after the surgery (p = 0.805). The mean number of postoperative antiglaucoma medications was significantly lower in the MMC group in the 1st postoperative month (p = 0.047) but no 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 6 months success rates in patients receiving AGV tube placement in CS.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chan Yun(김찬윤) ORCID logo https://orcid.org/0000-0002-8373-9999
Bae, Hyoung Won(배형원) ORCID logo https://orcid.org/0000-0002-8421-5636
Lee, Kwanghyun(이광현) ORCID logo https://orcid.org/0000-0002-1587-3387
Lee, Sang Yeop(이상엽) ORCID logo https://orcid.org/0000-0002-3834-7953
Lee, Jihei Sara(이지혜)
Choi, Wungrak(최웅락) ORCID logo https://orcid.org/0000-0002-3015-2502
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