Primary low-risk trabeculectomy augmented with low-dose mitomycin-C

Abstract

Purpose

To present outcome data on low risk primary trabeculectomy augmented with low dose peroperative (0.1 mg/mL for 1 minute) mitomycin-C (MMC).

Methods

Retrospective case note review. All cases of trabeculectomy utilizing MMC augmentation at a concentration of 0.1 mg/mL with an application time of 1 minute and at least 1 year follow-up during the study period were included. Only first eyes were included. Patient demographics and postoperative course including complications, interventions, and outcomes were documented and analyzed.

Results

Fifty-nine trabeculectomies that met the inclusion criteria were identified. Mean age of cases was 70.8 years. Mean follow-up time was 19.3 months. Bleb leaks occurred in 16 (27.1%) cases. Only one case required surgical intervention in the form of resuturing after 14 days. At 1 year, there was a reduction in mean number of topical medications from 2.70 to a mean of 0.07. Unqualified success (intraocular pressure [IOP] at 1 year of less than 16 mmHg without medication) was achieved in 49 cases (83.1%). Mean IOP was reduced from the preoperative value of 23.1 mmHg (SD 5.8) to 13.5 mmHg (SD 5.0) (p<0.001).

Conclusions

Our data suggest that a primary trabeculectomy augmented with a low dose of MMC is a safe and effective procedure for IOP reduction in patients with a low risk of trabeculectomy failure.