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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 five minutes during trabeculectomy operation for twenty patients with glaucoma (20 eyes). MMC was applied on episclera without any contact with the wound. Patients were followed-up for12 months. Success of operation by the use of high-dosage MMC was defined with intraocular pressure (IOP) between five and 20 mmHg 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 & 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.
Dr. M.A. Fereshtekhou, Department of Ophthalmology, Nikoukari Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. drferesh@yahoo.com
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)