Comparison of trabeculectomy with mitomycin C in patients of vernal
keratoconjunctivitis with steroid induced glaucoma versus patients with
high risk glaucoma
Sadia Farooq, Ukasha Dukht, Ali Tayyab.
Abstract
Objective
The study set out to compare the outcome of trabeculectomy augmented with mitomycin C in patients who had vernal keratoconjunctivitis with steroid induced glaucoma to those with other high risk features.
Method
A prospective comparative analysis of 35 eyes of 35 patients (14 vernal keratoconjunctivitis and 21 who had other high risks conditions in their eye) who underwent trabeculectomy with mitomycin C was carried out. The “vernal keratoconjunctivitis” group consisted of patients who developed glaucoma secondary to use of topical steroids. The “high risk” group consisted of patients who had developed glaucoma after cataract extraction (pseudophakic glaucoma), lens subluxation, penetrating keratoplasty, whose glaucoma was uncontrolled after trabeculectomy (failed trabeculectomies) as well as patients who had, iridocorneal endothelial (ICE) syndrome and those with uncontrolled glaucoma on maximal tolerated medical therapy. Successful outcome was defined as intraocular pressure (IOP) < 20 mmHg at two months with no medications. Failure was defined as IOP > 21 mmHg at two months. The patients were followed-up for two years for development of complications.
Results
Trabeculectomy for vernal keratoconjunctivitis had a significant lowering of IOP < 21 mmHg (p=0) as compared to high risk group (p=0.55).
Conclusions
Trabeculectomy with mitomycin C is a safe and effective procedure for steroid induced glaucoma in patients with vernal keratoconjunctivitis who develop glaucoma secondary to use of topical steroids. (Rawal Med J 2009; 34: 54-57).
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