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[Primary trabeculectomy for open-angle glaucoma with mitomycin C]

T Hara1, S Shirato, N Miyata

  • 1Department of Ophthalmology, University of Tokyo School of Medicine, Japan.

Nippon Ganka Gakkai Zasshi
|November 1, 1995
PubMed
Summary
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Trabeculectomy with mitomycin C effectively lowers intraocular pressure (IOP) in open-angle glaucoma patients. This surgical approach demonstrated significant IOP control, though some complications require monitoring.

Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Glaucoma Research

Background:

  • Open-angle glaucoma management often requires surgical intervention to control intraocular pressure (IOP).
  • Trabeculectomy is a common surgical procedure, and adjuncts like mitomycin C are used to enhance its efficacy.
  • Previous studies have compared various antimetabolic agents in glaucoma surgery.

Purpose of the Study:

  • To evaluate the postoperative intraocular pressure (IOP) control and complication profile of trabeculectomy with mitomycin C.
  • To assess the effectiveness of this surgical technique in primary open-angle glaucoma patients without prior ocular surgery.
  • To compare the outcomes with historical data of trabeculectomy using other agents.

Main Methods:

  • A cohort of 70 patients (80 eyes) with open-angle glaucoma underwent trabeculectomy with 0.04% mitomycin C for 3 minutes.

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  • Patients were followed for 7-24 months post-surgery.
  • Intraocular pressure (IOP) control was analyzed using the Kaplan-Meier method at 24 months.

    • Main Results:

    • The IOP control rate at 24 months was 81.6% without antiglaucoma medications and 92.0% with medications.
    • These results were significantly higher (p < 0.05) compared to historical data using 5-fluorouracil or no antimetabolic agents.
    • Complications included shallow anterior chamber (23%), choroidal detachment (18%), hypotonus maculopathy (9%), and cataract progression (7%).

    Conclusions:

    • Trabeculectomy combined with mitomycin C appears to be an effective surgical option for managing primary open-angle glaucoma.
    • While effective, potential complications necessitate careful postoperative monitoring and management.
    • The use of mitomycin C demonstrates superior IOP control compared to alternative antimetabolic agents in this patient group.