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Adjunctive mitomycin C in Molteno implant surgery
T W Perkins1, U F Cardakli, J R Eisele
1Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison 53705-3631.
Ophthalmology
|January 1, 1995
Summary
Adjunctive intraoperative mitomycin C significantly improved intraocular pressure control in complicated glaucoma patients receiving Molteno implants. This approach offers a better chance of achieving target IOPs compared to Molteno implantation alone.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Pharmacology
Background:
- Complicated glaucoma presents challenges for intraocular pressure (IOP) management.
- Double-plate Molteno implantation is a surgical option for advanced glaucoma.
- Adjunctive therapies are explored to enhance surgical outcomes.
Purpose of the Study:
- To evaluate the efficacy of intraoperative mitomycin C as an adjunct to double-plate Molteno implantation.
- To determine if mitomycin C can lower intraocular pressure in patients with complicated glaucoma.
Main Methods:
- A pilot study compared 21 patients receiving mitomycin C with 18 historical controls.
- Mitomycin C (0.5 mg/ml) was applied intraoperatively for 5 minutes.
- Life-table analysis assessed IOP control, defined by specific mmHg ranges and need for further intervention.
Main Results:
- The mitomycin C group showed significantly higher success rates (68% at 1 year) versus the control group (17% at 1 year; P = 0.006).
- Complication rates, including vision loss and re-operation, were slightly higher but not statistically significant in the mitomycin C group.
Conclusions:
- Intraoperative mitomycin C combined with Molteno implants may improve IOP control in complicated glaucoma.
- This adjunctive therapy offers a promising strategy for achieving target low teens IOPs.