TRABECULECTOMY WITH BRIEF EXPOSURE OF MITOMYCIN-C

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.