PRIMARY GLAUCOMA TRIPLE PROCEDURE IN PATIENTS WITH PRIMARY OPEN-ANGLEGLAUCOMA - THE EFFECT OF MITOMYCIN-C IN PATIENTS WITH AND WITHOUT PROGNOSTIC FACTORS FOR FILTRATION FAILURE

PURPOSE: To investigate the effect of adjunctive mitomycin C on primar y glaucoma triple procedure in patients with primary open angle glauco ma with and without one or more of the prognostic factors for filtrati on failure of primary glaucoma triple procedure. Those factors include being of African American race, having a preoperative intraocular pre ssure of 20 mm Hg or more on maximum tolerated medications, and being on two or more medications preoperatively. METHODS: Study patients con sisted of 197 consecutive patients with primary open-angle glaucoma wh o were randomly assigned to receive either no adjunctive mitomycin C ( 101 eyes of 101 patients) or to receive adjunctive subconjunctival mit omycin C (96 eyes of 96 patients) during the primary glaucoma triple p rocedure. Kaplan-Meier survival analysis comparisons were made between respective subgroups with and without prognostic indicators for filtr ation failures using a relatively stringent set of criteria for filtra tion success of primary glaucoma triple procedure. RESULTS: There was no statistically significant (P = .117) difference in filtration succe ss of primary glaucoma triple procedure between the control and mitomy cin C groups. Adjunctive mitomycin C significantly (P < .05) improved the filtration outcome of the primary glaucoma triple procedure in the subgroups with each of the three prognostic factors for filtration fa ilure of primary glaucoma triple procedure. On the other hand, in the subgroups without the prognostic factors, adjunctive mitomycin C did n ot significantly (P > .05) change the filtration outcome of the primar y glaucoma triple procedure. CONCLUSION: These findings establish the basis for selective use of mitomycin C in patients with primary open-a ngle glaucoma undergoing primary glaucoma triple procedure. (C) 1998 b y Elsevier Science Inc. All rights reserved.