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March 02, 2020
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Intraoperative, postoperative MMC helps control IOP in Ahmed glaucoma valve implantation

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Jessica Kang

WASHINGTON — Patients undergoing Ahmed glaucoma valve implantation who received intraoperative and postoperative mitomycin C experienced better IOP control and required fewer glaucoma drops for up to 12 months after surgery, according to a speaker here.

“The findings suggest that intra- and postoperative mitomycin C may result in better IOP control at postoperative month 1, which is a crucial time period as this is when patients are vulnerable to a hypertensive phase,” Jessica Kang, MD, said at the American Glaucoma Society annual meeting.

Kang presented the results of the first study to evaluate the use of both intraoperative and postoperative MMC during Ahmed glaucoma valve (AGV, New World Medical) implantation. Kang and colleagues compared IOP and the number of medications used at baseline in 53 eyes implanted with an AGV and treated with an intraoperative 0.1 mL subconjunctival injection of MMC. This cohort was compared with 52 eyes treated with balanced salt solution at the time of AGV implantation. Subconjunctival injections of MMC and balanced salt solution were performed in the cohorts at postoperative week 1 and month 1.

Patients undergoing Ahmed glaucoma valve implantation who received intraoperative and postoperative mitomycin C experienced better IOP control and required fewer glaucoma drops for up to 12 months after surgery.

At 1 month, the mean IOP in the MMC group was 12.2 mm Hg, which was statistically significantly lower than the 17.8 mm Hg mean IOP in the balanced salt solution group (P < .001). The MMC group demonstrated lower IOP at 2 months, 3 months, 6 months and 12 months, but the difference did not reach statistical significance, Kang said.

The number of glaucoma medications required for the MMC group at 1 month was 1.0 compared with 1.3 for the BSS group, a statistically significant difference (P = .03). The number of required glaucoma medications remained statistically significantly less through 12 months for the MMC group, she said. – by Robert Linnehan

Reference:

Kang J. Treatment outcomes in the Ahmed with mitomycin C (AMC) study after one year of follow-up. Presented at: American Glaucoma Society annual meeting; Feb. 27-March 1, 2020; Washington.

Disclosure: Kang reports no relevant financial disclosures.