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Trabeculectomy with mitomycin C for post-keratoplasty glaucoma.
M Ishioka1, J Shimazaki, J Yamagami
1Department of Ophthalmology, Tokyo Dental College, Japan.
The British Journal of Ophthalmology
|June 30, 2000
Summary
Trabeculectomy with mitomycin C significantly improves outcomes for post-keratoplasty glaucoma patients. This surgical approach offers a better prognosis and reduced intraocular pressure compared to trabeculectomy alone.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Corneal Transplantation
Background:
- Glaucoma is a common complication following penetrating keratoplasty.
- Managing post-keratoplasty glaucoma requires effective surgical interventions.
Purpose of the Study:
- To evaluate the efficacy of trabeculectomy with and without mitomycin C in treating glaucoma after corneal transplantation.
- To compare surgical success rates and complication profiles between the two treatment groups.
Main Methods:
- Retrospective study of 34 eyes (32 patients) undergoing trabeculectomy for post-keratoplasty glaucoma.
- Comparison between 26 eyes receiving mitomycin C and 8 eyes without.
- Success defined as intraocular pressure < 21 mmHg with or without medication; mean follow-up 22.3 months.
Main Results:
- Trabeculectomy with mitomycin C achieved a success rate of 73.0% versus 25.0% without (p=0.0219).
- Kaplan-Meier analysis indicated a better prognosis with mitomycin C (p=0.0182).
- Improved intraocular pressure and reduced medication use were observed with mitomycin C, with manageable side effects and graft clarity rates of 69.2% vs 37.5%.
Conclusions:
- Trabeculectomy augmented with mitomycin C demonstrates superior efficacy for managing glaucoma after keratoplasty.
- The addition of mitomycin C improves surgical success and long-term prognosis without significant adverse effects on the corneal graft.