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Related Experiment Videos

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
PubMed
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.

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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.

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  • 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.