Outcomes of same-site re-operation with minimal use of mitomycin in failed trabeculectomy

Abstract

To evaluate efficacy and safety of same site re-operation in eyes with failed trabeculectomy. A retrospective, noncomparative, interventional case series. We reviewed the medical records of 35 eyes of 35 patients who underwent same-site re-operation for failed trabeculectomy. The surgery involved a fornix-based peritomy at the same site as the previous trabeculectomy with application of 0.2 mg/mL mitomycin for 1 min. Primary outcome measures were intraocular pressure (IOP) control and number of antiglaucoma medications at last follow-up. Success rates were defined according to criteria (A) IOP ≤ 21 mmHg or (B) IOP ≤ 18 mmHg, with or without antiglaucoma medication. The mean age of the patients was 43.3 ± 18.0 years and 62.9 % were male. The mean follow-up was 13.6 ± 12.0 months (range 6-49 months). At final follow-up, mean baseline IOP was reduced from 27.2 ± 8.0 to 16.6 ± 7.5 mmHg (p < 0001). The mean number of antiglaucoma medications was reduced from 2.8 ± 0.8 to 1.0 ± 1.3 (p < 0001). This study supports the efficacy and safety of same-site re-operation with minimal use of mitomycin C for management of failed filtering blebs following trabeculectomy.