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. 2011:5:1679-86.
doi: 10.2147/OPTH.S25611. Epub 2011 Dec 1.

Trabeculectomy with double low dose of mitomycin C - two years of follow-up

Donato Errico  1 , Francesca Scrimieri, Roberta Riccardi, Romolo Fedeli, Giancarlo Iarossi
Affiliations

Trabeculectomy with double low dose of mitomycin C - two years of follow-up

Donato Errico et al. Clin Ophthalmol. 2011.

Abstract

Purpose: To evaluate the efficacy and the safety of a surgical technique in which classic trabeculectomy ab externo is performed with a double application of low-dose mitomycin C (MMC) in uncontrolled open-angle glaucoma (OAG) patients.

Method: A consecutive series of 43 white patients (43 eyes) with uncontrolled primary OAG underwent trabeculectomy surgery. A double application of MMC (0.1%) was performed: the first under the Tenon's capsule for 3 minutes, and the second below the scleral flap for 1 or 2 minutes, according to the risk factors. Complete success was defined as intraocular pressure (IOP) <14 mmHg without any additional glaucoma surgery or medication. Qualified success was defined as IOP <14 mmHg with additional needling revision.

Results: Mean preoperative IOP was 29.9 mmHg (SD 3.8) for all eyes evaluated. At 1 day postoperative, mean IOP was 6.7 mmHg (SD 1.26). At the end of the first 2 weeks postoperative, mean IOP was 8.6 mmHg (SD 1.7), at 12 months mean IOP was 11.3 mmHg (SD 1.4; P < 0.0001) and at 24 months mean IOP was 11.4 mmHg (SD 1.5; P < 0.0001). At 3 months, two eyes (5.4%) underwent needling of the bleb for cystic blebs formation.

Conclusion: In this study we presented the results after 2 years of follow-up of OAG undergoing trabeculectomy with dual administration of MMC (0.1 mg/mL). After 24 months, complete success was achieved in 93% of patients and a qualified success in 100% of patients.

Keywords: glaucoma; mitomycin C; trabeculectomy.

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Figures

Figure 1
Figure 1
0.1 mg/mL mitomycin bubble inside Tenon’s capsule.
Figure 2
Figure 2
4 × 4 mm piece of sponge soaked in mitomycin C (0.1 mg/mL or 0.2 mg/mL) under dissected scleral flap.
Figure 3
Figure 3
Eye appearance after surgery; releasable suture is visible.
Figure 4
Figure 4
Mean IOP evolution pre- and postoperative: (A) patients (B) controls. Abbreviation: IOP, intraocular pressure.
Figure 5
Figure 5
Appearance of bleb without cysts (E2-V3-H2).
Figure 6
Figure 6
Appearance of bleb with cysts (E2-V1-H2).
See this image and copyright information in PMC

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