ESCRS - PP23.05 - Impact Of Different Mitomycin-C Application Methods During Trabeculectomy On Bleb Morphology And Function

Impact Of Different Mitomycin-C Application Methods During Trabeculectomy On Bleb Morphology And Function

Published 2023 - 41st Congress of the ESCRS

Reference: PP23.05 | DOI: 10.82333/mdyj-yk19

Authors: Elif Akbaş Ulman* 1 , Mine Esen Baris 1 , Suzan Guven Yilmaz 1

1Ophthalmology,Ege University Faculty of Medicine,Izmir,Türkiye

To evaluate the impact of different mitomycin-C (MMC) application methods (subconjunctival injection/sponge application) during trabeculectomy on bleb morphology and surgical results, using optical coherence tomography angiography (OCTA).

The medical records of the patients who underwent trabeculectomy with MMC as the first glaucoma surgery at a referral center between November 2021 and September 2022 were evaluated retrospectively.

All patients underwent complete ophthalmological examination in each visit and OCTA was performed at the postoperative 3rd month. Bleb wall thickness (BWT) and bleb height (BH) were measured and density of microcysts were recorded, from the OCTA images. Bleb vascularization density (BVD, %) and complete avascular area (CAA, %) were calculated using ImageJ software. Correlation of OCTA findings with clinical findings and the effects of different MMC application methods on surgical outcomes were analyzed.

The median age of 32 patients (F:5/M:27) was 65 (20-79) years. MMC was applied as subconjunctival injection (SCI) in 16 eyes (50%, 0.1 mg/ml) and with sponge in 16 eyes (50%, 0.2 mg/ml-2 min) during the operation. There was no significant difference between the SCI and sponge groups in terms of postoperative mean intraocular pressure (IOP), BVD, CAA, BWT, BH and needling requirement (p=.57, p=.79, p=.92, p=.08, p=22, p=.68) respectively). Bleb height (r=-0.51), microcyst density (r=-0.87) and complete avascular area (%) (-0.87) were negatively correlated, whereas BVD was positively correlated (r=0.76) with postoperative IOP. The percentage of CAA in OCTA was found to be correlated with microcyst density (r=0.81).

Different application methods of MMC during trabeculectomy does not change the bleb function and morphology and seems not to have an impact on surgical success.