alexa Trabeculectomy with mitomycin C versus Ahmed glaucoma implant with mitomycin C for treatment of pediatric aphakic glaucoma.


Optometry: Open Access

Author(s): Pakravan M, Homayoon N, Shahin Y, Ali Reza BR, Pakravan M, Homayoon N, Shahin Y, Ali Reza BR

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Abstract PURPOSE: To compare trabeculectomy with mitomycin C (T+MMC) and Ahmed glaucoma implant with MMC (AGI+MMC) in treatment of aphakic glaucoma in children below 16 years of age. DESIGN: Randomized clinical trial. PARTICIPANTS: Subjects less than 16 years of age who had previously undergone anterior lensectomy and vitrectomy for treatment of congenital cataract with unresponsive aphakic glaucoma (at least on 2 medications) were allocated in 2 groups: trabeculectomy with MMC (group A, 15 eyes) and AGI (group B, 15 eyes). METHODS: Fifteen eyes in each group underwent T+MMC or AGI+MMC. Complete and qualified success were defined as 5< or =intraocular pressure< or =21 mm Hg without and with medication, respectively. MAIN OUTCOME MEASURES: Intraocular pressure, visual acuity, and complications. RESULTS: Complete and qualified success rates were 33.3\% and 40\% in T+MMC group versus 20\% and 66.7\% in AGI+MMC group, respectively (P=0.36). Mean follow-up was 14.8 and 13.1 months and complication rates were 40\% and 26.7\% (P=0.44), respectively. CONCLUSIONS: T+MMC and AGI+MMC are comparable in terms of success rate and complications in pediatric aphakic glaucoma. PRECIS: This randomized clinical trial demonstrated comparable safety and efficacy for MMC trabeculectomy and AGI in the treatment of pediatric aphakic glaucoma. This article was published in J Glaucoma and referenced in Optometry: Open Access

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