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Abstract #3669 Published in IGR 4-2
Efficacy and safety of mitomycin C in primary trabeculectomy: five-year follow-up
Bindlish R; Condon GP; Schlosser JD; D'Antonio J; Lauer KB; Lehrer ROphthalmology 2002; 109: 1336-1341; discussion 1341-1342
PURPOSE: To examine the five-year complications and results of primary trabeculectomy with mitomycin C (MMC). DESIGN: Retrospective, noncomparative interventional case series. PARTICIPANTS: One hundred and twenty-three eyes that underwent primary trabeculectomy with MMC between December 1991 and March 1995. METHODS: All patients received standard trabeculectomy performed by one of two surgeons, using a Weck cell-soaked pledget of MMC, 0.25, 0.33, or 0.5 mg/ml, for 0.5 to five minutes. Laser suture lysis was performed postoperatively for intraocular pressure control. MAIN OUTCOME MEASURES: The incidence of complications, including hypotony with or without maculopathy, bleb leak or blebitis, pressure control, and medication reduction at yearly intervals. RESULTS: Mean preoperative and year 5 postoperative intraocular pressures (IOP) were 25.79 and 9.91 mmHg (p < 0.05, paired t test). Hypotony (IOP < 6) occurred in 42.2% of eyes after a mean follow-up of 26.1 months. Hypotony maculopathy occurred in 8.9% of eyes at mean follow-up of 33.7 months. Bleb leak occurred in 14.6% of eyes at a mean follow-up of 27.9 months. Blebitis occurred in 5.7% of eyes at a mean follow-up of 35.4 months, and endophthalmitis occurred in 0.8% of eyes at 15 months; 14.9% of eyes lost four lines of visual acuity. The single predictor for the development of late-term hypotony was IOP one month after operation (p < 0.05). CONCLUSIONS: Primary mitomycin trabeculectomy significantly lowers IOP at five years, but is associated with a high incidence of delayed hypotony.
Dr. R. Bindlish, Department of Ophthalmology, Allegheny General Hospital, 420 East North Avenue, Pittsburgh, PA 15212, USA
Classification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
