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Trabeculectomy with mitomycin C versus trabeculectomy alone for juvenile primary open-angle glaucoma
Jen-Chia Tsai1, Hsueh-Wen Chang, Chien-Neng Kao
1Department of Ophthalmology, Chang Gung Memorial Hospital, Kaohsiung, Taiwain, ROC. tsai4118@ms26.hinet.net
Summary
Initial trabeculectomy with mitomycin C for juvenile open-angle glaucoma showed no significant difference in success rates compared to trabeculectomy alone. However, the mitomycin C group had a higher incidence of hypotony maculopathy.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Surgical Outcomes
Background:
- Juvenile primary open-angle glaucoma (JPAG) requires effective surgical management.
- Trabeculectomy is a common surgical procedure for glaucoma.
- The role of adjunctive mitomycin C in JPAG surgery is debated.
Purpose of the Study:
- To compare the intermediate-term outcomes of initial trabeculectomy with versus without adjunctive mitomycin C in JPAG.
- To evaluate success rates and complication profiles between the two surgical approaches.
Main Methods:
- Retrospective analysis of 44 eyes from 36 JPAG patients.
- Comparison between initial trabeculectomy with mitomycin C (15 eyes) and trabeculectomy alone (29 eyes).
- Three-year follow-up assessing success probability and complications.
Main Results:
- Cumulative success probability at 3 years was 73% for mitomycin C group vs. 68% for control (p=0.89).
- Higher incidence of hypotony maculopathy in the mitomycin C group (20% vs. 0%, p=0.034).
- Lower intraocular pressure in the mitomycin C group (10.8 mmHg vs. 13.3 mmHg, p=0.017) among successfully treated patients.
Conclusions:
- No significant difference in cumulative success probability between initial trabeculectomy with or without mitomycin C for JPAG.
- Increased risk of hypotony maculopathy associated with mitomycin C use.
- Caution is advised regarding the routine use of initial trabeculectomy with mitomycin C for JPAG.