Effectiveness of high-dosage mitomycin-C in trabeculectomy: High risk patients with glaucoma

Abstract

Objective: To evaluate the effectiveness of high-dosage mitomycin-C (MMC) in patients with glaucoma undergoing trabeculectomy and its use for preventing failure of operation. Methodology: We used 0.5mg/ml MMC for 5 minutes during trabeculectomy operation for twenty patients with glaucoma (twenty eyes). MMC was applied on episclera without any contact with the wound. Patients were followed-up for twelve months. Success of operation by the use of high-dosage MMC was defined with intraocular pressure (IOP) between 5 and 20mmHg together with decline of snellen visual acuity not more than two lines. Results: Trabeculectomy together with high-dosage MMC led to decline of IOP on an average of 66%. The mean preoperative IOP was 34.8 +/- 5.16 mmHg and the mean postoperative IOP was 12.6 +/- 2.93 mmHg. The difference between preoperative and postoperative IOP was statistically significant (p<0.05). Of the twenty patients, 100% had successful operation, 90% had formation of thin avascular bleb, 25% had postoperative leakage, 20% had shallow anterior chamber, 20% had choroids effusion, and 10% had cataract at postoperative evaluation. Conclusion: High-dosage Mitomycin-C is safe Et effective for high risk patients with glaucoma who undergo trabeculectomy and it leads to significant control of IOP if postoperative complications are managed and treated as well.