Visual and Surgical Outcomes of Primary Phacotrabeculectomy with Mitomycin C in Patients with Open Angle and Pseudoexfoliative Glaucoma in Sana’a (Yemen)
Introduction: The study aimed to assess the visual and surgical outcomes and the occurrence of intraoperative and postoperative complications after primary phacotrabeculectomy with intraoperative use of Mitomycin C (MMC) in primary open angle (POAG) and pseudoexfoliative glaucoma (PXF) patients.
Methods: This cross-sectional hospital-based study included 100 consecutive eyes of 82 patients with POAG (n = 79) and PXF (n = 21), who had planned phacotrabeculectomy with MMC at the Glaucoma Unit in Magrabi Hospital, from January 1 to December 31, 2013. Data were collected using a standardized form that included patient demographic information, ocular characteristics and postoperative complications, including hypotony (defined as intraocular pressure (IOP) < 6 mmHg) and shallow anterior chamber (AC).
Result: The mean age ± standard deviation (SD) of patients was 60.5± 13.35 years with a (range, 17 – 80 years old). Hundred eyes of 82 patients underwent phacoemulsification and trabeculectomy with MMC. A statistically significant improvement was detected in the mean IOP and mean number of glaucoma medication postoperative. The IOP decreased from a preoperative mean of 24.7 to a mean of 15.6 mm Hg (p <0.001; z= -8.240) and glaucoma medications decreased from 2.1 to 0.6 (p = <0.001; z= -8.688). A statistically significant improvement was detected in postoperative BCVA in which the mean log MAR (Logarithm of the Minimum Angle of Resolution) Best Corrected Visual Acuity (BCVA) improved from preoperative level of 1.0 to 0.5 (p<0.001).
Conclusion: The surgical technique used in this study appears to be an effective and safe procedure at restoring good visual acuity, controlling and lowering of intraocular pressure and reducing the postoperative complication rate.
Keywords: Cataract, Glaucoma, Intraocular Pressure, Phacotrabeculectomy, Yemen.