A Retrospective Non-Randomized Case Study Analysis of Mitomycin-C Efficacy in Patients Undergoing Combined Phacotrabeculectomy at a Tertiary Care Hospital in Salem, India

Arul Balasubramanian; Ezhilvendhan Kalaimamani; Rositta Siby Siby Kuttummelkattil; Kannan Murali; Karthick Kumar; Kothai Ramalingam

doi:10.52756/ijerr.2023.v36.010

Arul Balasubramanian Department of Pharmacy Practice, Vinayaka Mission’s College of Pharmacy, Vinayaka Mission’s Research Foundation, (Deemed to be University), Salem, Tamilnadu, India https://orcid.org/0000-0001-6896-5069
Ezhilvendhan Kalaimamani Department of Ophthalmology, Vinayaka Mission’s Kirupananda Variyar Medical College & Hospitals, Vinayaka Mission’s Research Foundation, (Deemed to be University), Salem, Tamilnadu, India https://orcid.org/0000-0002-8410-6755
Rositta Siby Siby Kuttummelkattil Department of Pharmacy Practice, Vinayaka Mission’s College of Pharmacy, Vinayaka Mission’s Research Foundation, (Deemed to be University), Salem, Tamilnadu, India https://orcid.org/0009-0007-5123-8958
Kannan Murali Department of Pharmacy Practice, Vinayaka Mission’s College of Pharmacy, Vinayaka Mission’s Research Foundation, (Deemed to be University), Salem, Tamilnadu, India https://orcid.org/0009-0004-3540-8943
Karthick Kumar Department of Pharmacy Practice, Vinayaka Mission’s College of Pharmacy, Vinayaka Mission’s Research Foundation, (Deemed to be University), Salem, Tamilnadu, India https://orcid.org/0009-0001-0583-2135
Kothai Ramalingam Department of Pharmacy Practice, Vinayaka Mission’s College of Pharmacy, Vinayaka Mission’s Research Foundation, (Deemed to be University), Salem, Tamilnadu, India https://orcid.org/0000-0002-4571-0917

DOI: https://doi.org/10.52756/ijerr.2023.v36.010

Keywords: Bleb, intra-ocular pressure, mitomycin-c, phaco-trabeculectomy, visual acuity

Abstract

Glaucoma and cataracts, which are major contributors to worldwide blindness, frequently occur together, requiring phacotrabeculectomy as the primary therapeutic approach. This study conducted a retrospective analysis of cases to evaluate the efficacy of Mitomycin-C (0.2mg/ml for 3 min) in phacotrabeculectomy, which is a combination surgical treatment that involves trabeculectomy and phacoemulsification. The study was conducted over six months, from January 2022 to June 2022, in a tertiary care hospital in Salem. An analysis was conducted on the records of 60 patients who underwent phacotrabeculectomy and met the inclusion criteria. The study included 60 patients, with 28 (47%) being men and 32 (53%) being females; of these, 22 (37%) underwent surgery on their right eye, while 38 (63%) underwent surgery on their left. Most patients belonged to the age bracket of 51-65 years. The grading of cataracts identified many forms, such as Nuclear Sclerosis (NS-1: 3%, NS-1 and PSC: 10%, NS-2: 17%, NS-2 and PSC: 23%, NS-3: 7%, PSC: 13%). The most prevalent type, affecting the majority (27%) of the population, was Senile Immature Cataract (SIMC). The average preoperative intraocular pressure was 22.4 ± 1.52 mmHg, and after the surgery, the pressure reduced dramatically to 13.20 ± 1.42 mmHg. The difficulties associated with blebs are resolved on their own. After the operation, there was an improvement in visual acuity. The average values increased from 0.86 ± 0.15 before the surgery to 0.22 ± 0.26 on day 1, 0.20 ± 0.23 on day 7, 0.19 ± 0.23 on day 14, 0.18 ± 0.19 on day 30, and 0.18 ± 0.19 on day 45. A paired t-test demonstrated a statistically significant difference (p=0.02) in postoperative visual acuity between day 1 and day 45. The study's findings indicate that Mitomycin-C is efficacious in phacotrabeculectomy, resulting in decreased intraocular pressure and enhanced visual acuity, with no notable problems. The findings provide valuable insights into managing concurrent glaucoma and cataracts, presenting a viable strategy in tertiary care settings.

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