Abstract

Purpose: To describe for the first time, a new approach of subconjunctival Mitomycin-C (MMC) injection at the end trabeculectomy for secondary glaucoma. Materials and Methods: This pilot study consisted of 4 eyes of 4 patients of uncontrolled secondary glaucoma. After preoperative glaucoma workup, all patients underwent standard trabeculectomy with subconjunctival MMC injection, 0.1ml (0.02mg) in superonasal quadrant at the end of surgery. Postoperative follow-up included assessment of visual acuity, intraocular pressure (IOP), bleb, anterior chamber depth and for any complications. The success criterion was IOP of ?21 mmHg. Results: The mean pre and postoperative IOP were 43 mmHg± 16.2 and 12.00mmHg ± 1.6 respectively with a success rate of 100% during a mean follow up of 15.5 months. Blebs were mildly elevated, diffuse and less avascular. No intraoperative complications were seen. Postoperative wound leak, flat anterior chamber, hypotony, choroidal detachment or endophthalmitis were not encountered. Conclusion: This novel approach of subconjunctival MMC injection at the end of trabeculectomy was found to be safe and highly effective in secondary glaucoma without any MMC related complications. Keywords: Mitomycin C, Subconjunctival injection, Secondary glaucoma, Trabeculectomy.

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