Comparison of Outcomes of Trabeculectomy with Viscoelastic Implant vs. Trabeculectomy with Mitomycin C (MMC)

Raheela Hafiz; Abdul Rauf; Shagufta Parveen; Taimoor Ashraf Khan; Shingrif Shabbir Khan; Atiya Iqbal

doi:10.51253/pafmj.v76iSUPPL-8.13478

Authors

Raheela Hafiz Department of Ophthalmology, Armed Forces Institute of Ophthalmology /National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Abdul Rauf Department of Ophthalmology, Armed Forces Institute of Ophthalmology /National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Shagufta Parveen Department of Ophthalmology, Armed Forces Institute of Ophthalmology /National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Taimoor Ashraf Khan Department of Ophthalmology, Armed Forces Institute of Ophthalmology /National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Shingrif Shabbir Khan Department of Ophthalmology, Armed Forces Institute of Ophthalmology /National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Atiya Iqbal Department of Ophthalmology, Armed Forces Institute of Ophthalmology /National University of Medical Sciences (NUMS), Rawalpindi, Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-8.13478

Keywords:

Glaucoma, Intraocular Pressure, Mitomycin C, Trabeculectomy, Viscoelastic Agents, Wound Healing

Abstract

Objective: To compare trabeculectomy with Mitomycin C (MMC) versus Trabeculectomy with Viscoelastic implant in regards to intraocular pressure (IOP) control, surgical success, and postoperative complications.

Study Design: Quasi-Experimental Study

Place & Duration of Study: Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi, Pakistan from April 2023 to April 2024

Methodology: A total of sixty patients (30 per group) with Primary Open-Angle Glaucoma (POAG) or Pseudoexfoliation Glaucoma (PXG) fulfilling the inclusion and exclusion criteria were selected. Patients in Group-A underwent trabeculectomy with MMC whereas those in Group-B underwent trabeculectomy with Viscoelastic implant. IOP measurements, bleb morphology, surgical success, and postoperative complications were noted over a 12-month period. Paired and independent t-tests, chi-square tests, and Kaplan-Meier survival analysis were conducted.

Results: At 12 months, mean IOP was comparable between MMC (15.4 ± 2.94 mmHg) and Viscoelastic implant (16.0 ± 3.37 mmHg) (p = 0.6). Complete success was attained in 63.3% of Group-A and 43.3% of Group-B (p = 0.121), while qualified success was 36.7% and 56.7%, respectively (p = 0.100). Postoperative complications were significantly lower in the Group-B (p = 0.001). No significant difference was seen in surgical survival (p = 0.739).

Conclusion: Both adjuncts effectively reduced IOP, but Viscoelastic implant demonstrated a superior safety profile. It may serve as a safer alternative to MMC, though studies with long-term control are needed to confirm sustained efficacy.