Trabeculectomy with mitomycin C for normal-tension glaucoma

A prospective investigation of the postoperative intraocular pressure level, visual function changes, and postoperative complications of trabeculectomy with adjunctive mitomycin C in normal-tension glaucoma.

Thirty-one patients (31 eyes) who underwent trabeculectomy with 0.4 mg/ml mitomycin C were studied. The preoperative intraocular pressure of the eyes ranged from 11 to 18 mm Hg with a mean (+/- SD) of 14.1 +/- 1.9 mm Hg. Follow-up examinations were performed at least once a month for 14-35 months (mean: 24.4 months).

Intraocular pressures decreased to between 4 and 14 mm Hg with a mean (+/- SD) of 8.4 +/- 2.4 mm Hg at the last three follow-up visits. The magnitude of the intraocular pressure reduction ranged from 1 to 10 mm Hg, with a mean of 5.8 mm Hg. Final measurements of postoperative intraocular pressure ranged between 5 and 12 mm Hg in 27 eyes (87%). Visual acuity deteriorated two lines or more in seven eyes, which was caused by cataract. The visual field deteriorated postoperatively in two eyes (6%): their respective postoperative intraocular pressures averaged 9.4 and 7.5 mm Hg. Hypotonous maculopathy developed in three eyes (10%).

Trabeculectomy with mitomycin C appears to have potential as a treatment modality of choice for normal-tension glaucoma, because a large majority of the patients in the present study achieved an intraocular pressure allegedly beneficial in managing normal-tension glaucoma.