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Trabeculectomy augmented with mitomycin C application under the scleral flap
S Beatty1, T Potamitis, S Kheterpal
1Birmingham and Midland Eye Centre, City Hospital NHS Trust.
The British Journal of Ophthalmology
|June 26, 1998
Summary
Trabeculectomy with mitomycin C under the scleral flap effectively lowers intraocular pressure (IOP) in high-risk patients. Preoperative risk factors did not significantly impact surgical success rates.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Surgical Techniques
Background:
- Glaucoma is a leading cause of irreversible blindness worldwide.
- Trabeculectomy is a common surgical procedure to lower intraocular pressure (IOP).
- Mitomycin C (MMC) is an antifibrotic agent used to enhance trabeculectomy success rates.
Purpose of the Study:
- To evaluate the safety and efficacy of trabeculectomy augmented with mitomycin C applied beneath the scleral flap.
- To assess the impact of preoperative risk factors on the outcomes of this surgical procedure.
Main Methods:
- A retrospective study of 72 high-risk eyes undergoing trabeculectomy with sub-scleral flap mitomycin C (0.2 mg/ml for 5 minutes).
- Eyes were categorized based on preoperative risk factors.
- Success was defined as IOP ≤ 21 mm Hg, with or without medication.
Main Results:
- Mean IOP decreased significantly from 28.4 mm Hg to 16.63 mm Hg (p < 0.0001).
- 72% of eyes achieved unqualified success (IOP ≤ 21 mm Hg without medication).
- Complication rates were favorable compared to other MMC administration methods.
Conclusions:
- Sub-scleral flap mitomycin C application during trabeculectomy is a safe and effective method for high-risk glaucoma patients.
- The incidence of complications like wound leak and hypotony was lower than with sub-Tenon's MMC.
- Preoperative risk factors did not influence the surgical outcome.