Can postoperative dexamethasone nanoparticle eye drops replace mitomycin C in trabeculectomy?
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Gottfredsdóttir, María Soffía
Ásgrimsdóttir, Guðrún Marta
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CitationJóhannesson G, Gottfredsdóttir MS, Ásgrimsdóttir GM, Loftsson T, Stefánsson E. Can postoperative dexamethasone nanoparticle eye drops replace mitomycin C in trabeculectomy? [published online ahead of print, 2020 Feb 17]. Acta Ophthalmol. 2020;10.1111/aos.14370. doi:10.1111/aos.14370
AbstractPurpose: Compare (a) nonmitomycin C (MMC) trabeculectomy and 1.5% dexamethasone nanoparticle (DexNP) eye drops postoperatively with (b) trabeculectomy with MMC and Maxidex® eye drops postoperatively. Methods: Randomized prospective single masked clinical trial with 20 patients with primary open-angle glaucoma undergoing primary trabeculectomy. The study group consisted of 10 patients without MMC intraoperatively and postoperative DexNP eye drops, and the control group consisted of 10 patients treated with MMC intraoperatively and postoperative Maxidex® . The drops were tapered out over 8 weeks. The main outcome measures were as follows: rates of complete success, that is intraocular pressure (IOP) within target pressures at different time-points without IOP-lowering medication, or reoperation. Secondary outcome measures included the following: relative success rate (with IOP-lowering medications), number of glaucoma medications and reoperations. Patients were followed for 36 months. Results: Both groups showed similar postoperative course and IOP reduction. Intraocular pressures (IOPs) in the DexNP group and in the control group were 25.6 and 24.4 mmHg, respectively, at baseline. Intraocular pressures (IOPs) were reduced to 13.2 and 14.5 mmHg at 12 months, 11.7 and 12.6 mmHg at 24 months and 11.7 and 12.1 mmHg at 36 months, respectively. There were no statistically significant differences between the groups in absolute (p = 0.36) or relative (p = 1.0) success rates, number of medications (p = 0.71) or reoperations (p = 1.0) between the groups at any time-point. Conclusions: DexNP eye drops are effective postoperative treatment following trabeculectomy. The potent anti-inflammatory and antifibrotic effect of DexNP may offer an alternative to mitomycin C in glaucoma surgery.
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Rights© 2020 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.
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