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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
PubMed
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.

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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.

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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.