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Mitomycin C-augmented trabeculectomy in refractory congenital glaucoma

A K Mandal1, D S Walton, T John

  • 1VST Centre for Glaucoma Care, L. V. Prasad Eye Institute, Hyderabad, India.

Ophthalmology
|June 1, 1997
PubMed
Summary

Mitomycin C-augmented trabeculectomy effectively lowers intraocular pressure in children with developmental glaucoma after conventional surgery failure. This procedure offers a high success rate with maintained visual acuity, making it a viable treatment option.

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Area of Science:

  • Ophthalmology
  • Pediatric Surgery
  • Glaucoma Management

Background:

  • Developmental glaucoma in children often requires surgical intervention.
  • Previous conventional glaucoma surgeries may fail, necessitating alternative treatments.
  • Mitomycin C is an antifibrotic agent used to enhance surgical outcomes.

Purpose of the Study:

  • To evaluate the safety and efficacy of mitomycin C-augmented trabeculectomy.
  • To assess outcomes in pediatric patients with developmental glaucoma previously treated with conventional procedures.

Main Methods:

  • Retrospective review of 19 eyes from 13 pediatric patients with developmental glaucoma.
  • Patients had previously failed conventional glaucoma surgeries.
  • Mitomycin C-augmented trabeculectomy (0.4 mg/ml for 3 minutes) was performed.

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Main Results:

  • Mean intraocular pressure (IOP) reduced from 33.74 mmHg to 11.89 mmHg (64.75% reduction, P < 0.0001).
  • Complete success was achieved in 94.74% of eyes over a mean follow-up of 19.52 months.
  • Visual acuity was maintained; one case of retinal detachment occurred but was successfully managed.

Conclusions:

  • Mitomycin C-augmented trabeculectomy is a safe and effective option for pediatric developmental glaucoma with prior surgical failure.
  • The procedure demonstrates a high success rate and favorable IOP reduction.
  • Further investigation may be needed to clarify the role of mitomycin C in rare complications like retinal detachment.