Impact of mitomycin C on surgical outcomes of PAUL glaucoma implant in neovascular glaucoma: 12-month follow-up results.

Abstract

Purpose: To evaluate the effectiveness of the PAUL Glaucoma Implant (PGI) and the adjunctive impact of intraoperative Mitomycin C (MMC) on surgical outcomes in patients with neovascular glaucoma (NVG).

Methods: This retrospective, comparative study included NVG patients who underwent PGI implantation. The cohort was divided into two groups: Group 1 (PGI without MMC) and Group 2 (PGI with MMC). Inclusion criteria encompassed a minimum 12-month postoperative follow-up and preoperative light perception. Surgical success was defined as maintaining intraocular pressure (IOP) between 6-21 mmHg without additional surgical intervention from the third month to the end of the 12-month follow-up. Failure due to hypotony was defined as an IOP ≤5 mmHg.

Results: The study enrolled a total of eighty-one patients, with 40 patients in Group 1 and 41 in Group 2. There were no significant differences in the demographic data and baseline ocular characteristics between the groups. Group 1 required more medications at 1, 3, 6, and 12 months (p < 0.05 for all). Surgical success rates at 12 months were 85% for Group 1 and 87.8% for Group 2, with no statistically significant difference between the groups (p = 0.140). Group 2 demonstrated a lower frequency of additional glaucoma procedures (p = 0.003) and delayed ripcord suture removal (p = 0.0001).

Conclusions: Incorporating MMC as an adjunct to PGI implantation may improve IOP control and decrease the requirement for additional medications and surgical interventions in NVG patients. However, there was no statistically significant difference between the two groups in terms of the surgical success criterion.