TRABECULECTOMY WITH MITOMYCIN-C - INTERMEDIATE-TERM RESULTS

Purpose: This study was performed to provide results 2 to 3 years afte r trabeculectomy with mitomycin C (MMC). Methods: A consecutive series of all 68 patients who underwent trabeculectomy with MMC was analyzed using Kaplan-Meier life-table statistics and compared with other publ ished retrospective analyses. Results: At 2- and 3-year follow-up exam inations, 59% (95% confidence interval [CI], 44-70%) and 47% (95% CI, 32-61%) of patients, respectively, avoided an intraocular pressure (IO P) of more than 21 mmHg or less than 20% below their preoperative leve l without glaucoma medication on two consecutive occasions more than 1 month apart after 3 months follow-up (75% [95% CI, 60-84%] and 70% [9 5% CI, 53-81%], respectively, with medication) and avoided additional glaucoma surgery. Loss of more than three lines of visual acuity on tw o occasions more than 1 month apart after 3 months follow-up occurred in 28% of patients (>2 lines in 44%) at 3 years. Nonreversible causes of loss of three lines of acuity occurred in 13% of patients. Complica tions requiring reoperation occurred in 16% of patients and included h ypotony maculopathy (4%) and late bleb leaks (4%). Conclusions: At the 3-year follow-up evaluation, trabeculectomy with MMC provided an appr oximately 50% chance of maintaining IOPs less than 21 mmHg and a more than 20% IOP reduction without concomitant use of glaucoma medication, which increased to 70% with the addition of medication. This procedur e was associated with an approximately 30% risk of substantial visual loss (approximately 15% nonreversible) and a 15% chance of reoperation for complications.