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Background: Post-operative scarring at the bleb site is a major factor in whether or not a trabeculectomy is successful. Mitomycin C and anti-vascular endothelial growth factor drugs like Aflibercept have been frequently used as supplementary treatments to trabeculectomy.Aim of the Study: This study aims to compare the efficacy of aflibercept and mitomycin c in trabeculectomy in patients with primary open-angle glaucoma.Patients and Methods: This prospective interventional study was carried out in Al-Azhar University Hospital in New Damietta from 2021 to 2023 on 40 patients with uncontrollable bilateral primary open angle glaucoma. Patients were divided into 2 groups each patient was represented in each group with one eye: Group 1, Included 20 eyes with medically uncontrolled primary open-angle glaucoma in which sub scleral trabeculectomy with intraoperative mitomycin C 0.3mg/1ml topical application was done. Group 2, Included 20 eyes with medically uncontrolled primary open-angle glaucoma in which subscleral trabeculectomy with intraoperative subconjunctival single dose of Eylea 2 mg / 0.05 mL was done.Results: According to the IOP, we found a statistically significant reduction in the IOP from 25 23-28 mmHg in group 1 and 25 23-28 mmHg in group 2 at the baseline to 14 13-15 mmHg in group 1 and 16 15-16 mmHg in group 2 at 12 months postoperative P = 0.001. In terms of the Bleb evaluation, the Mainz score was used for the Bleb assessment all over the follow-up periods. It consists of seven main domains, bleb height, peripheral vascularity, central vascularity, transparency, microcyst formation, and conjunctival mobility. We found no statistically significant difference between the 2 groups as regards all Mainz domains over the follow-up periods P > 0.05 for all.Conclusion: The use of intraoperative subconjunctival single-dose Aflibercept in trabeculectomy is safe effective and comparable to the use of MMC in terms of the advantage of avoiding the potentially dangerous complications related to MMC use.
Elmaksoud et al. (2024) studied this question.