E-PTFE (Gore-Tex) implant with or without low-dosage mitomycin-C as an adjuvant in penetrating glaucoma surgery: 2 year randomized clinical trial
| Autor: | Alessandra Casuccio, Fabio Bocchetta, Lucio Zeppa, Salvatore Cillino, Gaetano Lodato, Francesco Pace, Daniele Morreale |
|---|---|
| Přispěvatelé: | CILLINO S, ZEPPA L, DI PACE F, CASUCCIO A, MORREALE D, BOCCHETTA F, LODATO G |
| Jazyk: | angličtina |
| Rok vydání: | 2008 |
| Předmět: |
Male
Intraocular pressure medicine.medical_specialty genetic structures medicine.medical_treatment Mitomycin Glaucoma Ocular Hypotension Trabeculectomy Kaplan-Meier Estimate law.invention Randomized controlled trial law penetrating glaucoma surgery medicine Glaucoma surgery Humans Postoperative Period Survival rate Polytetrafluoroethylene Intraocular Pressure E-PTFE (Gore-Tex)implant Aged Dose-Response Relationship Drug business.industry Mitomycin C General Medicine Prostheses and Implants Middle Aged medicine.disease randomized clinical trial Surgery low-dosage mitomycin-C Ophthalmology Chemotherapy Adjuvant Anesthesia Female Implant business |
| Popis: | Purpose: To test the expanded polytetrafluoroethylene (ePTFE) as a new adjuvant in trabeculectomy. Methods: Consecutive glaucoma surgical inpatients were observed at the Department of Ophthalmology of Palermo University. Sixty patients (60 eyes) were randomly assigned to undergo trabeculectomy (T), trabeculectomy with mitomycin-C (TMMC), with ePTFE (TG) or with mitomycin-C and ePTFE (TGMMC). Postoperative visits were scheduled at 24 hr, 7 days, 1, 3, 6, 12, 18 and 24 months. Complete success and qualified success were assessed at two target intraocular pressure (IOP) levels – £21 and £17 mmHg – by Kaplan–Meier curves. Results: The postoperative IOP reduction was significant (P < 0.01) at the endpoint in all groups, with a mean IOP of 16.9 (±2.9), 16.2 (±2.7), 15.3 (±3.4) and 15.2 (±4.3) mmHg in T, TMMC, TG and TGMMC eyes, respectively. No intergroup difference was found at either IOP targets. The Kaplan–Meier curves relating to either the £21 mmHg or the £17 mmHg target IOP did not show significant intergroup differences for complete and qualified success rate. When ePTFE was used, a trend favouring the medium-term survival rate was noted. No adverse reaction to the ePTFE was present, and no membrane extrusion or conjuctival erosion were noted in any cases. Hypotony was significantly more frequent (P = 0.035) in groups without ePTFE. Moreover, the late MMC-related complications were more frequent when MMC was applied. Conclusion: Expanded polytetrafluoroethylene implant in trabeculectomy is well tolerated and could act as a filtration modulating device. Therefore, it is useful in reducing early hypotony-related complications and contributes to attaining medium-term IOP control that is comparable to the low-dosage MMC. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|