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International Ophthalmology
Published in: International Ophthalmology 10/2019

01-10-2019 | Glaucoma | Original Paper

Comparison of the effect of mitomycin C and bevacizumab–methylcellulose mixture on combined phacoemulsification and non-penetrating deep sclerectomy surgery on the intraocular pressure (a clinical trial study)

Authors: Ali Mostafaei, Nazli Taheri, Morteza Ghojazadeh, Atena Latifi, Neda Moghaddam

Published in: International Ophthalmology | Issue 10/2019

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Abstract

Purpose

Comparison of the effect of mitomycin C (MMC) versus bevacizumab–methylcellulose mixture (BMM) on combined phacoemulsification and non-penetrating deep sclerectomy surgery on the intraocular pressure in patients with open-angle glaucoma was made.

Methods

The current study is a controlled, randomized, double-blind clinical trial. Thirty-eight patients were enrolled, with a total of 40 eyes, and underwent a combined phacoemulsification and non-penetrating deep sclerectomy surgery from 2016 to 2017. MMC with concentration of 0.2 mg/mL for 2 min was used for 20 eyes before separating the scleral flap, and 0.3 mL of BMM (bevacizumab 1.25 mg incorporated into 2% methylcellulose) was injected subconjunctivally following surgery. The success rate of surgery was categorized as complete, relative and failure. Fisher’s exact, Mann–Whitney U and Chi-square tests were employed to data analysis. A p value < 0.05 was supposed significant.

Results

Patients had the same distribution in terms of age, sex, type of glaucoma and type of cataract. Patients were followed up for a mean of 6 months. The mean intraocular pressure before surgery in the MMC group was 24.85 ± 2.83 mmHg with 3.2 ± 0.523 anti-glaucoma drugs, which reached 13.75 ± 3.552 mmHg with 0.15 ± 0.489 anti-glaucoma drugs at the latest visit. The average intraocular pressure before surgery in the BMM group was 24.45 ± 2.48 mmHg with 2.9 ± 0.641 anti-glaucoma drugs, which reached 15.40 ± 3.267 mmHg with 0.25 ± 0.55 anti-glaucoma drug at the last follow-up. The intraocular pressure was notably lower in the MMC group than BMM group 6 months after surgery. There was not a significant difference from the aspect of success rate and failure rate among the two groups at the 6-month follow-up (p = 0.135).

Discussion

Based on the results of this study, MMC and bevacizumab–methylcellulose both seem to be effective in the success of combined phacoemulsification and non-penetrating deep sclerectomy surgery, but MMC decreases intraocular pressure in patients at 6 months post-surgery.
Literature
1.
Panahibazaz MR, Zamani M, Sharifipoor F et al (2015) Intraoperative mitomycin-C versus bevacizumab on success rate of phacotrabeculectomy. Persian J Med Sci. 1:41–45
2.
Sengupta S, Venkatesh R, Ravindran RD et al (2012) Safety and efficacy of using off-label bevacizumab versus mitomycin C to prevent bleb failure in a single-site phacotrabeculectomy by a randomized controlled clinical trial. J Glaucoma 21:450–459PubMedCrossRef
3.
Burr J, Azuara-Blanco A, Avenell A (2005) Medical versus surgical interventions for open angle glaucoma. Chochrane Database Syst Rev 18:CD004399
4.
Anand N, Chunxiao B et al (2015) Deep sclerectomy with bevacizumab and mitomycin C: a comparative study. J Glaucoma 24:25–31PubMedCrossRef
5.
Akkan JU, Cilsim S (2015) Role of subconjunctival bevacizumab as an adjuvant to primary trabeculectomy: a prospective randomized comparative 1-year follow-up study. J Glaucoma 24:1–8PubMedCrossRef
6.
Nilforushan N, Yadgari M, Kish SK et al (2012) Subconjunctival bevacizumab versus mitomycin C adjunctive to trabeculectomy. Am J Ophthalmol 153:352–357PubMedCrossRef
7.
Hitchings RA, Grierson I (1983) Clinico pathological correlation in eyes with failed fistulizing surgery. Trans Ophthalmol Soc UK 103(pt 1):84–88PubMed
8.
Charnock-Jones DS (2005) Vascular endothelial growth factors (VEGFs), their receptors and their inhibition. Cell Trans 21(1):1–5
9.
Murakami M, Iwai S, Hiratsuka S et al (2006) Signaling of vascular endothelial growth factor receptor-1 tyrosine kinase promotes rheumatoid artritis through activation of monocytes/macrophages. Blood 108:1849–1856PubMedCrossRef
10.
11.
Yamamoto T, Varani J, Soong HK et al (1990) Effects of 5-fluorouracil and mitomycin C on cultured rabbit subconjunctival fibroblasts. Ophthalmology 97:1204–1210PubMedCrossRef
12.
Skuta GL, Beeson CC, Higginbotham EJ et al (1992) Intraoperative mitomycin versus postoperative 5-fluorouracil in high risk glaucoma filtering surgery. Ophthalmology 99:438–444PubMedCrossRef
13.
Kitazawa Y, Kawase K, Matsushita H et al (1991) Trabeculectomy with mitomycin: a comparative study with fluorouracil. Arch Ophthalmol 109:1693–1698PubMedCrossRef
14.
Singh K, Mehta K, Shaikh NM et al (2000) Trabeculectomy with intraoperative mitomycin C versus 5-fluorouracil. Prospective randomized clinical trial. Ophthalmology 107:2305–2309PubMedCrossRef
15.
The Fluorouracil Filtering Surgery Study Group (1989) Fluorouracil filtering surgery study one-year follow-up. Am J Ophthalmol 108(625–635):309
16.
Ferrara N, Houck KA, Jakeman LB et al (1991) The vascular endothelial growth factor family of polypeptides. J Cell Biochem 47:211–218PubMedCrossRef
17.
Bates DO, Jones RP (2003) The role of vascular endothelial growth factor in wound healing. Int J Low Extrem Wounds 2:107–120PubMedCrossRef
18.
Van Bergen T, Vandewalle E, Van de Viere S et al (2011) The role of different VEGF isoforms in scar formation after glaucoma filtration surgery. Exp Eye Res 93:689–699PubMedCrossRef
19.
Li Z, Van Bergen T, Van de Viere S et al (2009) Inhibition of vascular endothelial growth factor reduces scar formation after glaucoma filtration surgery. Invest Ophthalmol Vis Sci 50:5217–5225PubMedCrossRef
20.
Stamper RL, Mcmenemy MG, Lieberman MF (1992) Hypotonous maculopathy after trabeculectomy with subconjunctiva 5-fluorouracil. Am J Ophthalmol 114(5):544–553PubMedCrossRef
21.
Watson PG, Jakeman C, Ozturk M, Barnett MF, Barnett F, Khaw KT (1990) The complications of trabeculectomy (a 20-year follow-up). Eye 4(Pt 3):425–438PubMedCrossRef
22.
Lama PJ, Fechtner RD (2003) Antifibrotics and wound healing in glaucoma surgery. Surv Ophthalmol 48(3):314–346PubMedCrossRef
23.
Wakabayashi T, Oshima Y, Sakaguchi H et al (2008) Intravitreal bevacizumab to treat iris neovascularization and neovascular glaucoma secondary to ischemic retinal diseases in 41 consecutive cases. Ophthalmology 115:1571–1580PubMedCrossRef
24.
Iliev ME, Domig D, Wolf-Schnurrbursch U et al (2006) Intravitreal bevacizumab (Avastin) in the treatment of neovascular glaucoma. Am J Ophthalmol 142:1054–1056PubMedCrossRef
25.
Moraczewski AL, Lee RK, Palmberg PF et al (2009) Outcomes of treatment of neovascular glaucoma with intravitreal bevacizumab. Br J Ophthalmol 93:589–593PubMedCrossRef
26.
Li Z, Van Bergen T, Van de Viere S et al (2009) Inhibition of vascular endothelial growth factor reduces scar formation after glaucoma filtration surgery. Invest Ophthalmol Vis Sci 50:5217–5225PubMedCrossRef
27.
Jampel HD, Solus JF, Tracey PA et al (2012) Outcomes and blebrelated complications of trabeculectomy. Ophthalmology 119:712–722PubMedCrossRef
28.
Bindlish R, Condon GP, Schlosser JD et al (2002) Efficacy and safety of mitomycin-C in primary trabeculectomy: five-year follow-up. Ophthalmology 109:1336–1341PubMedCrossRef
29.
Metadata
Title
Comparison of the effect of mitomycin C and bevacizumab–methylcellulose mixture on combined phacoemulsification and non-penetrating deep sclerectomy surgery on the intraocular pressure (a clinical trial study)
Authors
Ali Mostafaei
Nazli Taheri
Morteza Ghojazadeh
Atena Latifi
Neda Moghaddam
Publication date
01-10-2019
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 10/2019
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-019-01073-0

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