In this study, mitomycin-C (MMC) al a concentration of 0.2 mg/mL was a
pplied intraoperatively for 1 minute in 11 consecutive primary trabecu
lectomies to increase the success of glaucoma-filtration surgery while
minimizing the incidence of postoperative complications resulting fro
m MMC use. The success criteria included a postoperative intraocular p
ressure (IOP) lower than 21 mmHg without treatment, a 20% or more drop
from preoperative IOP levels, and a visual loss limited to one or few
er lines of Snellen acuity. The procedure was considered successful in
10 eyes (90.9%), with a mean follow-up period of 25.6 weeks. Blebs we
re ischemic and microcystic in all successful eyes at the time of the
last follow up. Postoperative complications included subconjunctival h
emorrhage, hyphema, conjunctival wound leak, and corneal epithelial de
fects. Complications related to low IOP, such as choroidal detachment
and hypotonic maculopathy, were not seen in any of the eyes. Although
the longer term of follow-up results of this regimen are not well know
n, this alternative intraoperative application of MMC at a concentrati
on of 0.2 mg/mL for 1 minute seems to control postoperative IOP effect
ively in primary trabeculectomies with fewer hypotony-related complica
tions.