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Fornix vs limbal-based trabeculectomy with mitomycin C
1Eye, Ear, Nose and Throat Centre, Queens Medical Centre, Nottingham NG7 2UH, UK.
Eye (London, England)
|September 25, 2004
Summary
Trabeculectomy with mitomycin-C (MMC) augmentation is effective for lowering intraocular pressure (IOP). Fornix-based flaps showed a lower risk of hypotony compared to limbus-based flaps, with similar visual outcomes.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Surgical Techniques
Background:
- Trabeculectomy is a common glaucoma surgery.
- Mitomycin-C (MMC) is frequently used to enhance surgical success.
- Conjunctival flap technique (limbus- vs. fornix-based) may influence outcomes.
Purpose of the Study:
- To compare the efficacy and safety of limbus-based versus fornix-based conjunctival flaps in trabeculectomy with MMC augmentation.
- To evaluate intraocular pressure (IOP) control, need for medication, and complications between the two flap types.
Main Methods:
- Retrospective review of 71 eyes from 59 patients undergoing trabeculectomy with MMC.
- Patients were divided into limbus-based (35 eyes) and fornix-based (36 eyes) flap groups.
- Minimum 6-month follow-up was required for inclusion.
Main Results:
- No significant differences in IOP, visual acuity, or need for intervention between groups.
- Fornix-based flaps had no cases of overdrainage/hypotony; limbus-based flaps had four cases.
- IOP < 18 mmHg achieved in 83% (limbus) vs. 94% (fornix) without medication.
- One case of endophthalmitis in the limbus-based group.
Conclusions:
- Trabeculectomy with MMC is safe and effective regardless of flap type.
- Fornix-based flaps may offer a reduced risk of hypotony compared to limbus-based flaps.
- Both techniques provide significant IOP reduction and visual rehabilitation.