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Effects of thick Tenon's capsule on primary trabeculectomy with mitomycin-C
Cengiz Akarsu1, Merih Onol, Berati Hasanreisoglu
1Department of Ophthalmology, School of Medicine, Gazi University, Ankara, Turkey. cengizakarsu@hotmail.com
Purpose:
To investigate the effects of thick Tenon's capsule on primary trabeculectomy with adjunctive mitomycin-C.
Methods:
In this prospective interventional case series of 45 consecutive uncomplicated glaucoma patients, 45 eyes with thick Tenon's capsule underwent primary trabeculectomy with intraoperative mitomycin-C (0.4 mg/ml for 3 min). Success was defined as intraocular pressure (IOP)
Results:
The mean follow-up period was 22.55 months. The mean preoperative IOP and number of medications were 28.91 +/- 7.06 mmHg and 1.68 +/- 0.73, respectively. The postoperative IOPs and the number of medications at all intervals were significantly lower than preoperative levels (p < 0.01 for each interval). The mean IOP was 11.03 +/- 3.93 mmHg (12.17 +/- 4.98 mmHg) at 24 months (12 months). Kaplan-Meier survival analysis revealed a qualified success rate of 93.1% (95.6%) after 24 months (12 months). During follow-up of the 45 eyes, 38 (84.4%) developed avascular thin-walled bleb, seven eyes (15.6%) had hypotony (IOP < 6 mmHg), 14 eyes (31.1%) had a shallow anterior chamber, and one eye (2.2%) had endophthalmitis.
Conclusions:
The use of mitomycin-C is associated with high success rates and good IOP control even in the presence of thick Tenon's capsule. However, thick Tenon's capsule does not seem to eliminate the development of complications in eyes undergoing primary trabeculectomy with mitomycin-C.