Title:
Postsurgical Intra Ocular Pressure Control Comparing Deep Sclerectomy Vs Trabeculectomy Both With MMC in Tripoli Eye Hospital- 2021-2022

Authors:
Eman S M Amr, DR Mansour Jeneva, Libya

Abstract:

Background: To evaluate post-operative outcomes of Trabeculectomy with MMC (TRAB) compared to Deep sclerectomy (DS) in terms of achieving the target intraocular pressure (IOP) 10 -15mmHg.

Methods: This study retrospectively analyzed 30 eyes divided  between TRAB and DS with MMC, performed in Tripoli Eye Hospital 2021-2022 respectively as registered and reviewed via hospital records. follow up was done during the period of six months. Patient were all  examined  and diagnosed as cases of advanced uncontrolled open angle glaucoma, any history of chronic illness as well as history of Glaucoma filtration surgery were excluded. Surgical success was defined as IOP 10-15mmHg in the first day post op until the period of six months without any addition of   post-operative medication or needling, bleb repair was needed during the follow up period

 

Results: Strikingly, the majority of TRAB and DS groups had 80% preoperative IOP of > 20mmHg on triple treatments or more, significant IOP decline had been noticed in the 1^st day and 1^st month post op to less than or = 10-14mmHg, (60%-40%) respectively in both surgeries. However, the IOP of <10 up to 15 maximumly in the 1^st to 6^thmonth postop 99%lower in TRAB Group compared to DS Group, which was 33% on the third to the sixth month additionally we add one medication maximum 2 drops in DS group so the IOP controlled back to be

 

In terms of complication post operatively had been noticed only in 3 patients from TRAB group, onlyone casewas low IOP of 2mmHg with FAC grade1 managed by Atropine ED and hourly steroid, the other 2 cases had increase IOP that controlled with bleb revision+MMC otherwise no more complications noticed during the follow up period.

 

Conclusion: Post-surgical outcome of DS and TRAB with MMC suggested almost similar capability of IOP control achievement between <10_15 mmHg, 73.1 during the first month without any treatment or intervention in the majority of cases, although, IOP <10-15mmHg was remarkably more controlled in the TRAB group up to the  6^th month in comparison to DS group on the long-term duration which fail to achieve the target IOP. When it comes to the complication on 3^rddays  in TRAB group >DS which was fortunately IOP  controlled back to normal,  DS groupunfortunately on the 3^rd month registered high IOP that managed with drops before 6 months in Tripoli Eye Hospital.

DOI: http://dx.doi.org/10.51505/ijmshr.2026.10314