Was to provide a solution to the problem of persistent silicone oil induced glaucoma (SOIG), which
represents a common type of intractable glaucoma that usually adds to the hazards of complicated vitreoretinal
surgeries. The trial aimed to evaluate the efficacy and safety of an augmented adjunctive approach of various
lines combined with surgical glaucoma treatment. Patients and Methods: Twenty-four eyes of 24 patients
presented with SOIG were included in this interventional case series clinical trial. All eyes underwent
trabeculectomy with intraoperative mitomycin-C (MMC) application plus bevacizumab injection (1.25 mg)
together with early postoperative topical MMC drops (0.03 mg/m1). The main outcome results included the
cumulative probability of surgical success, intraocular pressure (10P) values, number of anti-glaucoma drugs
needed, corrected distance visual acuity, any reported complication or additional intervention. Results: This
combined approach achieved a cumulative probability of success of 0.765 at the end of the 24 months study
period and was in a range of 0.883 at 2 weeks and 0.647 at 6 months. Complete success was achieved in a
range of 82.4% at 2 weeks and 35.3% at 18 and 24 months. There were always highly statistically significant
decreases in the mean 10P values and numbers of the given 10P-lowering drugs at all postoperative time
points (P was always <0.001). All complications were controlled with no major drawbacks. No significant
adverse effects were caused by this combined approach. Conclusion: The combined approach could present
an efficient, safe, familiar, and applicable treatment strategy for the treatment of persistent SOIG. It can
provide a favorable long-term outcome representing a simple solution to the problem of persistent SOIG, which
represents a challenging type of refractory glaucoma. |
