EFFECTIVENESS AND COMPLICATIONS OF MITOMYCIN-C USE DURING PEDIATRIC GLAUCOMA SURGERY

Purpose: To examine the safety of mitomycin C (MMC) use in pediatric g laucoma surgery. Design: Retrospective interventional case series. Par ticipants: One hundred eighty pediatric glaucoma patients younger than 7 years of age (254 eyes) who underwent glaucoma surgery and were fol lowed for at least 1 year participated. Interventions: Surgeries consi sted of trabeculectomy or combined trabeculotomy-trabeculectomy with a djunctive use of MMC. Main Outcome Measures: Control of intraocular pr essure (IOP) and occurrence of complications were measured. An IOP bel ow 21 mmHg without any additional medical or surgical treatment was co nsidered a success. Results: Primary congenital glaucoma was present i n 98% of the patients. Sixty percent had a trabeculectomy, and 40% had a trabeculotomy-trabeculectomy. The combined surgery was performed mo stly in infants up to I year of age. Complications were cystic bleb (1 9), bleb leak (4), retinal detachment (3), flat anterior chamber (3), cataract (2), and endophthalmitis (1), Children younger than 2 years o f age had fewer complications but higher failure rates. The combined p rocedure in infants up to 2 years of age was moderately more successfu l (57%) than trabeculectomy alone (39%), Minimal complications seen in this group were more likely related to young age than to the type of surgery. Complications increased with time after surgery, with most oc curring 2 years or more after surgery. Conclusions: Success of MMC-aug mented glaucoma filtering surgery increased with age, as did the compl ication rate. Serious complications were uncommon in the authors' grou p of pediatric patients up to now. However, complications related to b leb thinning increased with time after surgery, and additional problem s can be anticipated with longer follow-up.