TRABECULECTOMY WITH LOW CONCENTRATION OF MITOMYCIN (0.2 MG ML FOR 1 MINUTE) - INDEPENDENT EVALUATION OF A RETROSPECTIVE NONRANDOMIZED PILOT-STUDY/

Background The application of anti fibroses agents during glaucoma sur gery leads to more satisfactory results with lower i.o. pressure, yet eliciting complications in wound healing, avascular filtering blebs an d frequent chronic hypotonias. In patients with lower risk for failure a reduction of concentration and application time of Mitomycin C shou ld minimise side effects while maintaining the beneficial effect of lo wer intraocular pressure. Patients and Methods 34 eyes of 32 patients (age 72+/-8) underwent trabeculectomy (14 combined with phacoemulsific ation and implantation of a foldable posterior chamber lens). During f iltering surgery, Mitomycin C (0.2 mg/ml for 1 min) was applied after preparation of the scleral flap. An 11.5+/-5.0 (3-21), month followup, 30 (34) eyes (88.2%) had an i.o. pressure of less than or equal to 21 mm Hg (14.0+/-4.3 mm Hg at the last control) without additional glauc oma medications. Results The majority of filtering blebs (30/34; 88.2% ) were well vascularised, often showing polycystic degenerations near the limbus. Only 3 eyes developed an avascular filtering bleb. No pers isting leaks were observed and only 2 of 34 eyes (5.9%) developed shor t transient hypotonia (IOP < 6 mm Hg). Conclusions Adjunctive treatmen t with low concentration of Mitomycin C during filtering surgery resul ts in good i.o. pressure with little risk of avascular bleb developmen t. A prospective, randomised trial is required to assess the safety an d efficacy of adjuvantive Mitomycin C treatment in low risk filtering surgery.