Dj. Annen et J. Sturmer, TRABECULECTOMY WITH LOW CONCENTRATION OF MITOMYCIN (0.2 MG ML FOR 1 MINUTE) - INDEPENDENT EVALUATION OF A RETROSPECTIVE NONRANDOMIZED PILOT-STUDY/, Klinische Monatsblatter fur Augenheilkunde, 206(5), 1995, pp. 300-302
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.