Torchynska N. An effectivness of operation the limb microtrephanation in combination with the intraoperative application of mitomycin-C for treatment of neovascular glaucoma.-

The study is devoted to the problem of development of microinvasive surgical technique which is able to reduce IOP without serious complications. The risk of increased cicatrization in zone of postoperative microfistula is reduced by using the electric microtrephan that allows to create the microcanals of 0,5 mm in diameter. Intraoperative application of antimetabolit mitomycin-C is intended to the reduction of cicatrization. One hundred and eighty two patients (182 eyes) with neovascular glaucoma have been followed up, one hundred and forty two patients (142 eyes) from the main group and forty patients (40 eyes) from the control group. All patients from the main group were operated on the limb microtrephanation, eighty two patients with application of mitomycin-C (the first group) and sixty patients without application of this medicine (the second group). The patients of the control group were operated on by cryopexia transconjunctival of the ciliary area. The intraoperative and postoperative complications of the limb microtrephanation have been as follows: hyphema is found in 31,7% of cases in the first group and in 28,3% of cases in the second group. Choroidal detachment is found in 2,4% of cases in the first group and in 1,6% of cases in the second group. Early and late results of intraocular pressure compensation after the limb microtrephanation have been studied. One month after the operation IOP 27mm Hg took place on 66 eyes (80,5%) in the first group and on 42 eyes (70,0%) in the second group, a year after the operation on 62 eyes (76%) in the first group and on 37 eyes (62%) in the second group, three years after the operation on 56 eyes (68%) in the first group and on 32 eyes (53%) in the second group.The prolonging action of the hypothensive effect of intraoperative application of mitomycin-C was revealed. One year after the operation IOP in the first group of patient was 22,07+ 1,3 and C=0,22+0,1. In the second group of patients IOP was 26,8+2,5 and C=0,19+0,05 with authentic difference. Absolute contra-indications for fulfilment the limb microtrephanation have not been observed. Neovascular glaucoma with absolute closing of the anterior chamber angle can be considered a relative contra-indication for the limb microtrephanation.