3-YEAR FOLLOW-UP OF TRABECULECTOMIES PERFORMED WITH DIFFERENT CONCENTRATIONS OF MITOMYCIN-C

BACKGROUND AND OBJECTIVE: Mitomycin-C is effective for improving succe ss rates of trabeculectomies. The authors sought to determine longterm success rates and complications by studying two widely used concentra tions. PATIENTS AND METHODS: Trabeculectomies were performed with mito mycin-C (MMC) in concentrations of 0.5 mg/ml (group 1) and 0.2 mg/ml ( group 2) in a prospective, nonrandomized fashion. Patients were observ ed for at least 3 years, and all follow-up data were analyzed in addit ion to the preoperative and postoperative conditions and complications . RESULTS: A total of 51 and 40 eyes (groups 1 and 2, respectively) we re observed for 3 years. The majority of the eyes had repeat trabecule ctomy. Complete surgical success was reached in 76% and 63%, respectiv ely. The mean intraocular pressure (IOP) in the two groups decreased s ignificantly, and the decrease was larger in the MMC 0.5 mg/ml group ( P < .015). The mean visual acuity did decrease in the two groups, but this was not significant. Complications included short-term and Long-t erm hypotony, conjunctival dehiscence, choroidal detachments, and endo phthalmitis. Trabeculectomies failed both within the first 3 months (n = 4; 4%) and later (n = 11; 12%). CONCLUSION: Three-year results of t rabeculectomies performed with MMC are promising. A dose-response effe ct of the concentration of MMC and IOP levels is present, suggesting t hat the higher concentration leads to lower IOP values. Despite the an timetabolic effect of MMC, trabeculectomies fail in both the short-ter m and the long-term.