Intermediate-term outcome of variable dose mitomycin C filtering surgery

Area of Science:

• Ophthalmology
• Surgical Innovation
• Glaucoma Research

Background:

• Trabeculectomy with mitomycin C (MMC) is a common glaucoma surgery.
• Short-term studies show high success rates for MMC trabeculectomy.
• Long-term outcomes beyond one year require further investigation.

Purpose of the Study:

• To evaluate the intermediate-term (1-3 years) visual and intraocular pressure (IOP) outcomes of trabeculectomy with adjunctive mitomycin C.
• To assess the sustained efficacy of MMC trabeculectomy in a predominantly white patient population.

Main Methods:

• Retrospective review of 157 patients (157 eyes) aged 18+ who underwent MMC trabeculectomy for uncontrolled glaucoma.
• MMC concentrations ranged from 0.2 to 0.5 mg/ml, applied for 30 seconds to 5 minutes.
• Analysis included eyes at high risk for failure and those with specific preoperative IOP levels.

Main Results:

• Mean preoperative IOP of 29.4 mmHg decreased to 13.0 mmHg at 1 year, 11.5 mmHg at 2 years, and 13.4 mmHg at 3 years.
• Cumulative survival rates (defined as no reoperation for IOP control) were 94.2% at 1 year, 92.1% at 2 years, and 88.7% at 3 years.
• Complications included cataract progression (31 eyes), hyphema (26 eyes), and choroidal detachment (21 eyes).

Conclusions:

• Mitomycin C filtering surgery provides sustained intraocular pressure reduction in the intermediate term (1-3 years).
• The surgical procedure demonstrates a favorable safety and efficacy profile for managing uncontrolled glaucoma over this period.