Deep sclerectomy with Mitomycin C and injectable cross-linked hyaluronic acid implant: Long-term results

Paolo Bettin, Federico Di Matteo, Alessandro Rabiolo, Marina Fiori, Carlo Ciampi, Francesco Bandello

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the long-term efficacy and safety of deep sclerectomy (DS) augmented with mitomycin C (MMC) and injectable cross-linked hyaluronic acid implant (Healaflow) in medically refractory glaucoma patients. Materials and Methods: Our study included 96 eyes of 83 consecutive patients with open-angle glaucoma undergoing MMC-DS with injectable cross-linked hyaluronic acid implant. Mean follow-up was 28.6±20.0 months. Variables analyzed were: intraocular pressure (IOP), best-corrected visual acuity, mean number of antiglaucomatous drugs, execution of postoperative maneuvres (goniopuncture, bleb needling, and laser lysis of scleral flap sutures). Tonometric success was defined by 2 different thresholds, specifically IOP≤21 mm Hg (criterion A) and ≤15 mm Hg (criterion B). The procedure was defined as a qualified success if reached with medication and as a complete success if reached without. Results: For criterion A, qualified and complete success rates were 96% and 94%, respectively, at 12 months, 95% and 92% at 24 months, and 92% and 89% at 36 months. For criterion B, qualified and complete success rates were 75% and 75%, respectively, at 12 months, 62% and 60% at 24 months, and 59% and 58% at 36 months. Goniopuncture was performed in 56 eyes (58%), bleb needling with 5-fluorouracil injection in 4 eyes (5.1%), and laser release of scleral flap sutures in 4 eyes (4%). Six eyes required additional filtering surgery. Conclusion: DS with Healaflow and MMC seems to be an effective and safe technique to lower IOP in patients affected by open-angle glaucoma, with few postoperative complications.
Original languageEnglish
Pages (from-to)e625 - e629
JournalJournal of Glaucoma
Volume25
Issue number6
DOIs
Publication statusPublished - 2016

Fingerprint

Mitomycin
Hyaluronic Acid
Injections
Open Angle Glaucoma
Blister
Intraocular Pressure
Sutures
Lasers
Filtering Surgery
Fluorouracil
Glaucoma
Visual Acuity
Safety
Pharmaceutical Preparations

Keywords

  • cross-linked hyaluronic acid implant
  • deep sclerectomy
  • glaucoma
  • mitomycin

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Deep sclerectomy with Mitomycin C and injectable cross-linked hyaluronic acid implant: Long-term results. / Bettin, Paolo; Di Matteo, Federico; Rabiolo, Alessandro; Fiori, Marina; Ciampi, Carlo; Bandello, Francesco.

In: Journal of Glaucoma, Vol. 25, No. 6, 2016, p. e625 - e629.

Research output: Contribution to journalArticle

Bettin, Paolo ; Di Matteo, Federico ; Rabiolo, Alessandro ; Fiori, Marina ; Ciampi, Carlo ; Bandello, Francesco. / Deep sclerectomy with Mitomycin C and injectable cross-linked hyaluronic acid implant: Long-term results. In: Journal of Glaucoma. 2016 ; Vol. 25, No. 6. pp. e625 - e629.
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abstract = "Purpose: To evaluate the long-term efficacy and safety of deep sclerectomy (DS) augmented with mitomycin C (MMC) and injectable cross-linked hyaluronic acid implant (Healaflow) in medically refractory glaucoma patients. Materials and Methods: Our study included 96 eyes of 83 consecutive patients with open-angle glaucoma undergoing MMC-DS with injectable cross-linked hyaluronic acid implant. Mean follow-up was 28.6±20.0 months. Variables analyzed were: intraocular pressure (IOP), best-corrected visual acuity, mean number of antiglaucomatous drugs, execution of postoperative maneuvres (goniopuncture, bleb needling, and laser lysis of scleral flap sutures). Tonometric success was defined by 2 different thresholds, specifically IOP≤21 mm Hg (criterion A) and ≤15 mm Hg (criterion B). The procedure was defined as a qualified success if reached with medication and as a complete success if reached without. Results: For criterion A, qualified and complete success rates were 96{\%} and 94{\%}, respectively, at 12 months, 95{\%} and 92{\%} at 24 months, and 92{\%} and 89{\%} at 36 months. For criterion B, qualified and complete success rates were 75{\%} and 75{\%}, respectively, at 12 months, 62{\%} and 60{\%} at 24 months, and 59{\%} and 58{\%} at 36 months. Goniopuncture was performed in 56 eyes (58{\%}), bleb needling with 5-fluorouracil injection in 4 eyes (5.1{\%}), and laser release of scleral flap sutures in 4 eyes (4{\%}). Six eyes required additional filtering surgery. Conclusion: DS with Healaflow and MMC seems to be an effective and safe technique to lower IOP in patients affected by open-angle glaucoma, with few postoperative complications.",
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