Efficacy of individual application of mitomycin C in combined trabeculectomy

Abstract

Objective To evaluate the efficacy and complications of trabeculectomy with individual application of mitomycin C (MMC) for primary open-angle glaucoma. Methods The data of 76 eyes of 48 patients with primary open-angle glaucoma who underwent trabeculectomy with individual application of MMC were reviewed. All patients underwent trabeculectomy with application of 0.3 mg/ml MMC for 2~5 min which accorded to the age, Tenon's capsule thickness and postoperative target intraocular pressure(IOP). Success rates were defined according to three criteria: (1) IOP ≤18 mmHg (1 mmHg=0.133 kPa)and IOP reduction ≥ 20%; (2) IOP ≤15 mmHg and IOP reduction≥25%; and (3) IOP≤12 mmHg and IOP reduction≥30%. The success rate, visual acuity, type of filtering blebs and complications after the surgery were observed. The follow-up duration was 12~36 months with average (21.50±2.67) months. Results Mean IOP decreased from (31.28±7.67)mmHg before surgery to (13.28±3.87) mmHg 1 year after the surgery (t=4.162, P=0.000). The success rates were 95.79%, 86.32% and 71.12% at 1 year after the surgery for the three criteria respectively. Type Ⅰ filtering blebs were observed in 32 eyes, and type Ⅱ in other 44 eyes. Seven eyes (9.21%) required one kind of antiglaucoma medications to control IOP. There were 8 eyes (10.53%) with shallow anterior chamber in the early stage after the surgery. No other complication were noted. Conclusion Trabeculectomy with individual application of MMC can effectively reduce IOP in open-angle glaucoma with few complications. Key words: Glaucoma; Trabeculectomy; Mitomycin C