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Abstract #9991 Published in IGR 5-3
Clinical experiences and results of application of mitomycin C in trabeculectomy
Laube T; Ritters B; Selbach M; Hudde TKlinische Monatsblätter für Augenheilkunde 2003; 618-624
BACKGROUND: Mitomycin C (MMC) used as an additive agent in glaucoma surgery has been shown to improve the postoperative results of intraocular pressure (IOP), but may also lead to higher incidences of postoperative wound healing disorders and of hypotonia with choroidal detachment. In this retrospective study, the levels of IOP, incidence of complications and changes in visual acuity (VA) were monitored. METHODS: Trabeculectomy was performed in 70 eyes (57 patients). During surgery MMC was applied in three different concentrations: 0.1 mg/ml MMC (n = 8), 0.2 mg/ml MMC (n = 53) and 0.4 mg/ml MMC (n = 9) for 2.5 minutes, respectively. Patients were re-examined one day, and at three and 12 months after surgery. RESULTS: IOP was lowered with high statistical significance at all dates of control examination whatever the concentration of MMC used. At the time of discharge from hospital the success rate without additional topical glaucoma medication was 96%, 78% after three months and 68% after 12 months. With glaucoma medication the success rate was 92% after three months and 85% after 12 months. Frequent complications were choroidal detachment in 40% and hypotonia in 21% of cases. VA did not change significantly during the follow-up period. CONCLUSIONS: This study underlines the efficacy of MMC as an additive agent in glaucoma surgery. However, considerable complications may be expected. Considering the effectiveness and the complication rate a concentration of 0.2 mg/ml MMC should be preferred.
Dr. T. Laube, Abteilung für Erkrankungen des vorderen Augenabschnitts, Universitätsklinikum Essen, Germany
Classification:
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)
