EPISCLERAL VERSUS COMBINED EPISCLERAL AND INTRASCLERAL APPLICATION OFMITOMYCIN-C IN TRABECULECTOMY

BACKGROUND AND OBJECTIVE: To determine whether intrascleral exposure t o mitomycin-C (MMC) improves the control of intraocular pressure (IOP) , increases the incidence of complications, or both. PATIENTS AND METH ODS: The authors retrospectively evaluated 38 eyes of 29 patients foll owing the intraoperative application of MMC (0.2 mg/ml; 5 minutes). In 21 eyes the MMC-soaked sponge was applied to the intact episclera (ep iscleral group). In 17 eyes, two sponges, one episcleral and the other intrascleral (sandwich group), were applied. The median follow-up tim es were 19.0 (episcleral group) and 24.0 (sandwich group) months. Outc ome measures were the IOP the number of medications, success rates, an d the incidence of complications, RESULTS: The only statistically sign ificant difference between the two groups was the 2-week postoperative IOP! which was significantly lower in the episcleral group (P=.0314). CONCLUSION: Because there is no additional benefit, the authors recom mend that the intrascleral application of MMC be avoided. However, the y did not observe increased complication rates when MMC was applied in this way.