|LETTER TO THE EDITOR
|Year : 2021 | Volume
| Issue : 1 | Page : 176-177
Comments on: Intraoperative injection versus sponge applied mitomycin C during trabeculectomy: One year study
Tanima Bansal, Monica Gandhi, Suneeta Dubey
Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
|Date of Web Publication||15-Dec-2020|
Dr. Tanima Bansal
Fellow, Glaucoma Services Dr. Shroff's Charity Eye Hospital, Daryaganj, New Delhi - 110 002
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Bansal T, Gandhi M, Dubey S. Comments on: Intraoperative injection versus sponge applied mitomycin C during trabeculectomy: One year study. Indian J Ophthalmol 2021;69:176-7
|How to cite this URL:|
Bansal T, Gandhi M, Dubey S. Comments on: Intraoperative injection versus sponge applied mitomycin C during trabeculectomy: One year study. Indian J Ophthalmol [serial online] 2021 [cited 2021 Jan 16];69:176-7. Available from: https://www.ijo.in/text.asp?2021/69/1/176/303269
We would like to appreciate the work of authors Maheshwari et al. on “Intraoperative injection versus sponge-applied mitomycin C during trabeculectomy: One-year study”.
We agree with the authors that mitomycin C (MMC) injection provides a predictable drug dose delivery. However, we would like to share our clinical experience that each eye undergoing trabeculectomy surgery behaves differently in terms of conjunctival thickness and friability. These parameters are more accurately assessed after conjunctival peritomy so an Intraoperative injection before peritomy, sometimes can mislead and may lead to injecting higher concentration than required. However, the concentration and duration of MMC can easily be manipulated in the sponge technique after assessing the conjunctiva.
As mentioned in the abstract, the concentration of MMC used in both the groups was similar, making them quite comparable. However, in the methodology, it is mentioned that the concentration of MMC used in group 1 (injection) was 0.02 mg/0.1 ml (0.2 mg/ml), whereas in group 2 (sponge) it was 0.4 mg/ml.
The time duration after which conjunctival peritomy was done post injection of MMC in group 1 is not clearly defined. Also, whether the milking was done post conjunctival injection; as these two steps play a role in determining the tissue contact of MMC. Pakravan et al. did conjunctival peritomy after 1 minute of injection, Guimaraes et al. did the peritomy right after the injection.
The authors have mentioned the number of eyes in the two groups. However, no detailed description was mentioned on the type of glaucoma, pre-existing risk factors in the two groups. This data will give insight regarding the distribution of glaucoma; risk factors in the two groups, which could invariably affect the results.
There is no detailed description of the number of postoperative visits of a patient, 5 FU injection interventions in each group.
Answers to the above queries will give us a better insight into intraoperative MMC injection technique.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Maheshwari D, Kanduri S, Rengappa R, Kadar MA. Intraoperative injection versus sponge-applied mitomycin C during trabeculectomy: One-year study. Indian J Ophthalmol 2020;68:615-9.
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Pakravan M, Esfandiari H, Yazdani S, Douzandeh A, Amouhashemi N, Yaseri M, et al
. Mitomycin C-augmented trabeculectomy: Subtenon injection versus soaked sponges: A randomised clinical trial. Br J Ophthalmol 2017;101:1275-80.
Guimarães ME, de Pádua Soares Bezerra B, de Miranda Cordeiro F, Carvalho CH, Danif DN, Prata TS, et al
. Glaucoma surgery with soaked sponges with mitomycin C vs sub-tenon injection: Short-term outcomes. J Curr Glaucoma Pract 2019;13:50-4.