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Evaluating CO2 laser-assisted sclerectomy surgery with mitomycin C combined with or without phacoemulsification in adult Asian glaucoma subjects

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Abstract

Purpose

To evaluate and compare outcomes of CO2 laser-assisted sclerectomy surgery (CLASS) with mitomycin C (MMC) combined with or without phacoemulsification in adult Asian glaucoma patients.

Design

Retrospective, comparative study.

Methods

Adult Asian glaucoma patients who underwent CLASS alone or combined with phacoemulsification using standardized surgery by two trained glaucoma surgeons between 2014 and 2016 were identified. The main measures of outcome were: intraocular pressure (IOP), use of supplemental medical therapy, best-corrected visual acuity (BCVA), microperforations, macroperforations, and repeated intervention(s) for glaucoma.

Results

Forty-one eyes who underwent CLASS alone (13 eyes) or combined with phacoemulsification (28 eyes) were included. Overall, BCVA improved from 0.28 ± 0.19 to 0.14 ± 0.17, and 0.17 ± 0.19, 0.22 ± 0.24, and 0.18 ± 0.23 at 6, 12, 24, and 36 months, respectively. Mean IOP dropped from 17.9 ± 4.7 mmHg to 14.6 ± 5.5, 13.9 ± 3.3, 14.3 ± 3.6, and 14.1 ± 3.7 mmHg, and average number of medications reduced from 2.9 ± 0.9 to 0.2 ± 0.6, 0.5 ± 0.9, 1.0 ± 1.2, and 1.3 ± 1.4 at the same time points. There was no statistically significant difference in BCVA, IOP, and medication reduction between the two groups.

Conclusions

CLASS combined with or without phacoemulsification was equally safe and effective, but yielded more modest results in our population.

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Funding

The authors did not receive any funding, grant, or other support for the submitted work.

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Authors and Affiliations

  1. Department of Ophthalmology, National Healthcare Group Eye Institute, Khoo Teck Puat Hospital, Yishun, Singapore

    Dawn Ching Wen Ho

  2. Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, 168751, Singapore

    Shamira A. Perera & Ching Lin Ho

  3. Singapore Eye Research Institute, 20 College Road Discovery Tower, Level 6 The Academia, Singapore, Singapore

    Shamira A. Perera, Myint Htoon Hla & Ching Lin Ho

  4. Duke-NUS Medical School, 8 College Road, Khoo Teck Puat Building, Singapore, Singapore

    Shamira A. Perera & Myint Htoon Hla

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  1. Dawn Ching Wen Ho
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  2. Shamira A. Perera
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Correspondence to Ching Lin Ho.

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Ho, D.C.W., Perera, S.A., Hla, M.H. et al. Evaluating CO2 laser-assisted sclerectomy surgery with mitomycin C combined with or without phacoemulsification in adult Asian glaucoma subjects. Int Ophthalmol 41, 1445–1454 (2021). https://doi.org/10.1007/s10792-021-01707-2

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  • DOI: https://doi.org/10.1007/s10792-021-01707-2

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