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Purpose <p>Trabeculectomy is the gold standard for glaucoma management, offering effective intraocular pressure reduction. The method of mitomycin C (MMC) application plays a critical role in surgical success. This study evaluates the impact of different MMC administration techniques on key clinical outcomes to inform surgical decision-making.</p> Methods <p>A systematic review was conducted by searching EMBASE, Medline, and CENTRAL, yielding 709 records. Dichotomous outcomes, including complete and qualified success, were analyzed using odds ratios (OR) with 95% confidence intervals (CI), while continuous outcomes, such as postoperative intraocular pressure (IOP), were evaluated using mean difference (MD) with 95% CI. Heterogeneity (I<sup>2</sup> &gt; 40%) prompted subgroup and sensitivity analyses to enhance the robustness of the findings.</p> Results <p>Our systematic review included 11 studies involving a total of 1,153 patients. The meta-analysis revealed that subconjunctival or subtenon injections significantly improve the complete success rates compared to soaked sponges MMC [OR = 1.44, 95% CI = (1.04, 1.99); Number Needed to Treat (NNT) = 12, 95% CI = (7, 104)]. However, no significant differences were observed in qualified success rates between injections and soaked sponges [OR = 0.67; 95% CI = (0.37, 1.22) and OR = 0.82; 95% CI = (0.36, 1.86), respectively]. Regarding postoperative IOP, injection methods also significantly reduced postoperative IOP compared to soaked sponges [MD: -0.69&#xa0;mmHg; 95% CI = (-1.30, -0.07)].</p> Conclusion <p>MMC injections provide superior complete success rates and better IOP control compared to soaked sponges. Further well-designed RCTs are required to determine their efficacy and safety.</p>

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Efficacy and safety of subconjunctival or subtenon injection versus soaked sponge mitomycin C in trabeculectomy: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年9月23日

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  • Chiao-Hsin Lan,
  • Ya-Hsin Yao,
  • Shih-Heng Hung,
  • Ke-Hung Chien,
  • Da-Wen Lu,
  • Wei-Ting Yen

摘要

Purpose

Trabeculectomy is the gold standard for glaucoma management, offering effective intraocular pressure reduction. The method of mitomycin C (MMC) application plays a critical role in surgical success. This study evaluates the impact of different MMC administration techniques on key clinical outcomes to inform surgical decision-making.

Methods

A systematic review was conducted by searching EMBASE, Medline, and CENTRAL, yielding 709 records. Dichotomous outcomes, including complete and qualified success, were analyzed using odds ratios (OR) with 95% confidence intervals (CI), while continuous outcomes, such as postoperative intraocular pressure (IOP), were evaluated using mean difference (MD) with 95% CI. Heterogeneity (I2 > 40%) prompted subgroup and sensitivity analyses to enhance the robustness of the findings.

Results

Our systematic review included 11 studies involving a total of 1,153 patients. The meta-analysis revealed that subconjunctival or subtenon injections significantly improve the complete success rates compared to soaked sponges MMC [OR = 1.44, 95% CI = (1.04, 1.99); Number Needed to Treat (NNT) = 12, 95% CI = (7, 104)]. However, no significant differences were observed in qualified success rates between injections and soaked sponges [OR = 0.67; 95% CI = (0.37, 1.22) and OR = 0.82; 95% CI = (0.36, 1.86), respectively]. Regarding postoperative IOP, injection methods also significantly reduced postoperative IOP compared to soaked sponges [MD: -0.69 mmHg; 95% CI = (-1.30, -0.07)].

Conclusion

MMC injections provide superior complete success rates and better IOP control compared to soaked sponges. Further well-designed RCTs are required to determine their efficacy and safety.