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Abstract #5725 Published in IGR 2-1
Outcome of trabeculectomy with mitomycin-C in the iridocorneal endothelial syndrome
Lanzl IM; Wilson RP; Dudley D; Augsburger JJ; Aslanides IM; Spaeth GLOphthalmology 2000; 107:295-297
PURPOSE: Eyes with iridocorneal endothelial (ICE) syndrome have a high risk of failure in glaucoma filtering surgery failing. The authors investigated the efficacy of trabeculectomy with intraoperative mitomycin-C application in these patients. DESIGN: A retrospective nonrandomized comparative trial with historical controls. PARTICIPANTS AND CONTROLS: Ten patients with unilateral iridocorneal endothelial (ICE) syndrome were reviewed. Their intraocular pressures could not be controlled medically. In five eyes, this was the primary surgery performed. Five of the patients had undergone prior intraocular pressure (IOP)-lowering surgery that had failed at the time of enrolment. Results were compared with previously published case series of similar patients treated with trabeculectomy alone or trabeculectomy and subconjunctival 5-fluorouracil injections. INTERVENTION: Intervention consisted of trabeculectomy with a limbus-based conjunctival flap and mitomycin-C application. The dosage of mitomycin-C was 0.4 mg/ml for one to four minutes (mean, 1.9 minutes). MAIN OUTCOME MEASURES: Adequate control of IOP (without medication lower than 21 mmHg). RESULTS: In eight eyes, the IOP remained well controlled (mean IOP, 12.1 mmHg) over the entire length of available of follow-up (mean, 14.9 months). Two eyes required implantation of an aqueous tube shunt at four and 11 months, respectively, after trabeculectomy with mitomycin-C. One eye experienced visual loss of three Snellen lines because of hypotony maculopathy. CONCLUSION: Trabeculectomy with mitomycin-C application offers a reasonable intermediate-term success rate in ICE patients, who are otherwise at high risk for failure of filtering surgery.
Dr. I.M. Lanzl, Augenklinik der Technischen Universität München, München, Germany
Classification:
9.4.2.1 Iridocorneal endothelial syndrome (ICE, incl. irisatrophy) (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera)
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
