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PURPOSE: The authors compared the effectiveness of trabeculectomy with mitomycin-C (MMC) in primary open-angle glaucoma in two groups with two different doses. PATIENTS AND METHODS: The first group consisted of 17 eyes of 17 patients that received MMC at a concentration of 0.5 mg/ml for three minutes to the episclera and two minutes under the scleral flap. The second group consisted of 13 eyes of 13 patients that received MMC at a concentration of 0.25 mg/ml for three minutes to the episcleral bed before the flap was dissected. RESULTS: The average follow-up was 20.7 months. Median values for preoperative intraocular pressure were 40 mmHg (range, 30-60) in the first group, and 44 mmHg (range, 21-57) in the second (p=0.93; Mann-Whitney U test). Median postoperative IOP was 4 mmHg (range, 1.1-20) in the first group, and 9 mmHg (range: 5-12) in the second (p=0.02; Mann-Whitney U test). Median percentage IOP drop was 89.6% (range, 58.3-98%) in the first group, and 80% (range, 59.091.2%) in the second (p=0.03; Mann-Whitney U test). The number of hypotonous eyes was smaller in the second group, and this was statistically significant (p=0.02; chi-square test). CONCLUSIONS: Reducing the dose and duration of the application of mitomycin-C resulted in a lower incidence of hypotonous eyes, and adjusting the dose of this antimetabolite to lower levels is necessary for the success and safety of the filtration surgery. LA: <#>
Dr. G.E. Mirza, Erciyes Universitesi Tip Fakultesi, 38039 Kayseri, Turkey
12.8.10 Woundhealing antifibrosis (Part of: 12 Surgical treatment > 12.8 Filtering surgery)