Large-area versus small-area application of mitomycin C during trabeculectomy
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Published on: March 7, 2017
Juliane Matlach1, Ermioni Panidou, Franz Grehn
1Department of Ophthalmology, University of Wuerzburg, Josef-Schneider-Strasse 11, Wuerzburg, Germany. j.matlach@augenklinik.uni-wuerzburg.de
Purpose:
To compare 2 different application methods of mitomycin C (MMC) in patients undergoing trabeculectomy.
Methods:
This retrospective trial compared outcomes of 191 eyes that underwent trabeculectomy with small-area (96 eyes; 50.3%) and large-area (95 eyes; 49.7%) MMC application. Main outcome measures were changes in intraocular pressure (IOP), required glaucoma medications, the frequency of complications, and postsurgical interventions.
Results:
Within both treatment groups, a highly significant IOP reduction was seen during follow-up (p < 0.0001). Statistical analyses revealed a significant difference in IOP between both groups. Patients treated with a larger size of surface area had a higher IOP reduction within the first postoperative year. Choroidal detachment, shallow anterior chamber, and bleb leak were seen more often in the large-area group with more aggressive MMC use. In contrast, complications associated with bleb failure such as bleb scarring were higher in the small-area group. Success rate was higher in the large-area MMC application group after 12 months.
Conclusions:
Large-area treatment seems to be a more efficient application method of MMC during trabeculectomy.
