MOLTENO IMPLANT WITH MITOMYCIN-C - INTERMEDIATE-TERM RESULTS

Purpose: The authors examine the intermediate-term effects of adjuncti ve intraoperative mitomycin C (MMC) in a cohort of patients who receiv ed double-plate Molteno implants for complicated glaucomas. Methods: A consecutive series of 21 patients who received MMC 0.5 mg/ml for 5 mi nutes as an adjunct to a double-plate Molteno implant was compared by life-table analysis to a historical control group of 18 patients who r eceived either no adjunct or 5-fluorouracil (5-FU) but no MMC. Results : At three years follow-up, 35% (95% confidence interval (CI), 15-57%) of patients who received MMC avoided failure criteria of intraocular pressure (IOP) less than 6 mm Hg or more than 21 mm Hg, addition of gl aucoma medication, reoperation for glaucoma, or tube removal. Seventee n percent (95% CI, 4-37%) of patients in the control group at three ye ars follow-up met similar criteria (p = 0.039), No late complications of tube erosion were seen in the MMC group. Conclusion: Intraoperative MMC offers an increased likelihood of a two-to three-year period of m edication-free IOP control in patients undergoing double-plate Molteno implants, compared to similar patients receiving 5-FU or no adjunctiv e antimetabolite therapy.