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[Trabeculectomy with mitomycin C. Study apropos of 30 cases]
S Bazin1, W Williamson, L Poirier
1Service d'Ophtalmologie, Hôpital d'Instruction des Armées Robert-Picqué, Villenave-d'Ornon.
Journal Francais D'Ophtalmologie
|January 1, 1995
Summary
Mitomycin C adjunct to trabeculectomy effectively lowers intraocular pressure in refractory glaucoma patients. This method shows promise as an alternative to 5-fluorouracil, with no major complications reported.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Glaucoma Management
Background:
- Refractory glaucoma poses a significant challenge to maintaining low intraocular pressure.
- Standard trabeculectomy success rates can be limited by ocular risk factors.
- Mitomycin C is explored as an adjunct to enhance filtering surgery outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of trabeculectomy with intraoperative Mitomycin C in refractory glaucoma.
- To compare outcomes with other series, including those using 5-fluorouracil.
- To analyze results based on glaucoma etiology and risk factors.
Main Methods:
- Trabeculectomy using a fornix-based conjunctival flap was performed on 30 eyes.
- Mitomycin C (0.4 mg/ml) was applied intraoperatively for three minutes.
- Follow-up averaged 6.4 months (range: 4-11 months).
Main Results:
- At six months, 65.2% of patients achieved intraocular pressure <21 mmHg without medication.
- The overall success rate for the procedure was 86.9%.
- No significant intraoperative or early postoperative complications were observed.
Conclusions:
- Intraoperative Mitomycin C is a potentially valuable adjunct for achieving target intraocular pressure in high-risk glaucoma surgery.
- Mitomycin C presents a viable alternative to postoperative 5-fluorouracil application.
- Further research is needed to assess potential late complications associated with Mitomycin C use.