Scientific correspondence
Long term results and complications of trabeculectomy augmented
with low dose mitomycin C in patients at risk for filtration failure
Robert Casson, Rubina Rahman, John F Salmon
Oxford Eye Hospital,
Woodstock Road, Oxford OX2 6HE, UK
Correspondence to: Mr John Salmon john.salmon{at}orh.nhs.uk
Accepted for publication 19 February 2001
AIM
To determine the
results and complications up to 5 years after trabeculectomy with
0.02% mitomycin C (MMC) in glaucoma patients at risk for failure of
filtration surgery.
METHODSA consecutive
series of 21 eyes from 20 patients who underwent trabeculectomy with
MMC 0.02%, with an exposure time of 2 minutes, was retrospectively
analysed and the results were compared with previously published data.
RESULTSThe mean
preoperative intraocular pressure (IOP) was 28 mm Hg on an average of
2.8 glaucoma medications, and the mean postoperative IOP after 3 years
was 14 mm Hg on an average of 0.4 medications. Three years after
trabeculectomy, 17 of 21 (80.9%) eyes had an IOP of less than 21 mm Hg
without medical treatment. Using Kaplan-Meier life table analysis the 5 year probability of an IOP less than 21 mm Hg without medication was
67% and with medication was 90%. Two patients required further
glaucoma surgery during the first postoperative year, and another
developed hypotonous maculopathy which was reversed after bleb
revision. Seven patients developed visually significant cataract as a
late consequence of the surgery. There were no bleb related infections.
CONCLUSIONIn the long
term MMC 0.02% used for 2 minutes intraoperatively is an effective
adjunctive treatment in glaucoma patients at risk for bleb failure and
in this dose is associated with few complications.
© 2001 by British Journal of Ophthalmology
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