ผลการรักษาโรคต้อหินด้วยวิธีผ่าตัดเปิดทางระบายน้ำจากลูกตา ออกสู่เยื่อบุตาขาวร่วมกับการใช้ Mitomycin C ในโรงพยาบาลสุโขทัย

Nithiracht Saenpen

Authors

Nithiracht Saenpen Department of Ophthalmology, Sukhothai Hospital

Keywords:

Glaucoma, Trabeculectomy, Mitomycin C, Intraocular pressure, Treatment outcomes

Abstract

Background: Glaucoma is a leading cause of permanent blindness. Trabeculectomy with Mitomycin C (MMC) is a standard surgical procedure for lowering intraocular pressure (IOP). Because surgical outcomes under routine care at Sukhothai Hospital have not been formally evaluated and may differ according to the local case mix and available resources, this study was undertaken.

Objective: This study aimed to evaluate IOP reduction, medication reduction, surgical success rates, and complications of trabeculectomy with MMC in patients with glaucoma at Sukhothai Hospital.

Methods: A retrospective descriptive study of glaucoma patients who underwent trabeculectomy with MMC (0.2 mg/ml for 2 minutes) at Sukhothai Hospital from 2020–2024. After excluding re-trabeculectomy and lost-to-follow-up cases, 167 eyes were analyzed. IOP, number of medications, and complications were recorded preoperatively and at 1 and 6 months postoperatively, Data were summarized using mean (SD) and frequency (percentage), as appropriate.

Results: Mean age was 60.9 ± 10.9 years; 50.3% were male. POAG was the most common diagnosis (47.9%). Mean IOP decreased from 27.3 ± 12.2 to 15.5 ± 8.2 mmHg at 1 month and 14.3 ± 8.2 mmHg at 6 months (p < .001). Complete success rate was 61.1% and overall success was 86.8% at 6 months. The median number of medications decreased from 4 (IQR 1–4) preoperatively to 0 (IQR 0–1) at 6 months postoperatively. Complications occurred in 42.5%, mostly flat or shallow bleb.

Conclusion: Trabeculectomy with MMC yielded a complete success rate of 61.1%, effectively lowering intraocular pressure and reducing the reliance on anti-glaucoma medications. This procedure is suitable for glaucoma patients inadequately controlled on medical treatment.

References

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