Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jan 29:9:187-91.
doi: 10.2147/OPTH.S70721. eCollection 2015.

Ocular surface disease in posttrabeculectomy/mitomycin C patients

Janice Lam  1 , Tina T Wong  2 , Louis Tong  3
Affiliations

Ocular surface disease in posttrabeculectomy/mitomycin C patients

Janice Lam et al. Clin Ophthalmol. .

Abstract

Background: Our aim was to describe the demographics, risk factors, clinical signs, severity, and outcome of ocular surface disease (OSD) in 12 patients who had undergone trabeculectomy augmented with mitomycin C (MMC).

Methods: Twelve glaucoma patients were referred to the Dry Eye Clinic (Singapore National Eye Centre) for further management of clinically significant OSD.

Results: Of the 15 eyes from 12 patients, 14 were treated with MMC and one with 5-fluorouracil. Mean age was 69.3±10.6 years and two-thirds were male. The median interval before onset of dry eye symptoms after surgery was 13.5 months. Mean tear breakup time (TBUT) was 5.32 seconds and mean Schirmer score was 6.14 mm/5 min. Possible major risk factors for OSD in the cases include limbal stem cell deficiency occurring from exposure to antimetabolites, chronic use of antiglaucoma medications prior to surgery, and the preoperative status of the ocular surface prior to disease onset. Treatment of OSD resulted in improved best corrected visual acuity (BCVA) in 50% of the patients, with a median gain of two-line improvement in BCVA.

Conclusion: OSD is a clinical problem often overlooked in patients who undergo antimetabolite-augmented filtration surgery. Recognition of the condition and appropriate treatment can improve patient symptoms and reduce health-care burdens on the economy.

Keywords: cornea; glaucoma; ocular surface; trabeculectomy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of IOP-lowering eyedrops used to treat glaucoma. Notes: Timolol maleate, a beta-adrenergic blocker, was the commonest IOP-lowering topical eyedrop used in these patients, followed by prostaglandin analogs and alpha-adrenergic blockers. In comparison, combination therapy and carbonic anhydrase inhibitors were used much less frequently in these patients. Abbreviations: IOP, intraocular pressure; CA, carbonic anhydrase.
Figure 2
Figure 2
Corneal epitheliopathy in OSD. Notes: Corneal epitheliopathy in these patients ranged from punctate epithelial erosions to epithelial defects, as seen in three different patients with eyes stained with fluorescein. Abbreviation: OSD, ocular surface disease.
See this image and copyright information in PMC

References

    1. The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007) Ocul Surf. 2007;5(2):75–92. - PubMed
    1. Chen PP, Yamamoto T, Sawada A, Parrish RK, 2nd, Kitazawa Y. Use of antifibrosis agents and glaucoma drainage devices in the American and Japanese Glaucoma Societies. J Glaucoma. 1997;6(3):192–196. - PubMed
    1. The epidemiology of dry eye disease: report of the Epidemiology Subcommittee of the International Dry Eye WorkShop (2007) Ocul Surf. 2007;5(2):93–107. - PubMed
    1. Taneri S, Koch JM, Melki SA, Azar DT. Mitomycin-C assisted photorefractive keratectomy in the treatment of buttonholed laser in situ keratomileusis flaps associated with epithelial ingrowth. J Cataract Refract Surg. 2005;31(10):2026–2030. - PubMed
    1. Roh DS, Funderburgh JL. Impact on the corneal endothelium of mitomycin C during photorefractive keratectomy. J Refract Surg. 2009;25(10):894–897. - PMC - PubMed