Intraocular Pressure Lowering Effect of Deep Sclerectomy with Mitomycin C and Loose Scleral Flap Suture in Open Angle Glaucoma

There are controversial reports regarding the long-term intraocular pressure (IOP) lowering effect of non-penetrating glaucoma surgery (NPGS). The reported complete success rates from studies in different populations around the world are 13% to 77%. This prospective study was aimed to evaluate the IOP lowering effect of deep sclerectomy with Mitomycin C (DSMMC) in a group of Iranian patients with open angle glaucoma. Ninety eyes of 87 patients with medically uncontrolled primary open angle glaucoma (POAG) were consecutively enrolled in this prospective study and were surgically treated by DSMMC. All patients had complete eye examination before and at regular intervals after the operation. Surgical success was considered for IOP of ≤21 mmHg. The mean age was 64±12 years; the mean follow-up was 33±22 months. The mean preoperative IOP of 42±13 mmHg was significantly decreased to the mean final IOP of 22±11 mmHg (P<0.001). The IOP lowering effect of surgery reduced by time (P<0.001). Cystic bleb was developed in 13.3% of eyes. The probability for an IOP≤21 mmHg was 35% without the use of antiglaucoma drops and 71% with or without the use of antiglaucoma drops. DSMMC could effectively reduce IOP in eyes with POAG and was accompanied by few operative complications. Most of the patients needed to continue using antiglaucoma drops after the operation. This procedure is not fair whenever low target IOPs are required.