Mitomycin-C in Combined or Two-Stage Procedure Trabeculectomy Followed by Penetrating Keratoplasty

Abstract

To evaluate the efficacy and safety of application of mitomycin-C (MMC) in combined and separate trabeculectomy and penetrating keratoplasty for the treatment of coexisting corneal disease and glaucoma. A retrospective evaluation of 11 eyes of 10 patients was conducted. A combined trabeculectomy with MMC and penetrating keratoplasty procedure was performed in eight eyes (group 1), and keratoplasty was performed after a previous trabeculectomy with MMC in three eyes (group 2). In group 1, seven of the eight eyes had controlled intraocular pressure (IOP) and clear corneal graft at the end of the follow-up period (range, 5-60 months; mean duration, 16.7 months). In group 2, all three eyes had controlled IOP at the end of the follow-up period (range, 4-30 months; mean duration, 14 months); two of these patients had clear corneal grafts, and graft failure occurred in the remaining patient. Complications included transient flat anterior chamber and corneal epithelial defects, each of which occurred in a single eye in group 1, and progressive cataract, which occurred in a single eye in group 2. Mitomycin-C was found to be safe and efficient in the present series, controlling IOP in 10 of 11 eyes (91%) with coexisting corneal disease and glaucoma. The transplanted corneas remained clear in 9 of 11 eyes (82%). Complications related to MMC included a reversible epithelial defect that occurred in one eye.