Adjunctive mitomycin C in Molteno implant surgery.
OBJECTIVE
The authors assessed the efficacy of adjunctive intraoperative mitomycin C to produce lower intraocular pressures (IOPs) in patients with complicated glaucoma who underwent double-plate Molteno implantation.


METHODS
A pilot series of 21 consecutive patients who underwent double-plate Molteno implantation with adjunctive intraoperative mitomycin C (0.5 mg/ml) for 5 minutes was compared with a historical control group who received Molteno implants without mitomycin C (n = 18). With failure defined as an IOP greater than 21 or less than 6 mmHg at two observations 1 month apart, the addition of medication, re-operation for glaucoma, or tube removal, a life-table analysis of IOP was performed on patients with at least 3 months' follow-up.


RESULTS
Success in the mitomycin C group was higher (68% at 1 year) than the control group (17% at 1 year; P = 0.006). Loss of more than one line of vision (33%) and re-operation for complications (including flat anterior chamber, choroidal detachment, and tube blockage) (38%) were slightly but not significantly more frequent in the mitomycin C group than in the control group.


CONCLUSIONS
This study suggests that intraoperative mitomycin C in conjunction with Molteno implant may offer a better chance of achieving target IOPs in the low teens in patients with complicated glaucoma than Molteno implantation alone.
Perkins
T W
TW
Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison 53705-3631.
Cardakli
U F
UF
Eisele
J R
JR
Kaufman
P L
PL
Heatley
G A
GA
D000328:Adult; D000368:Aged; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007430:Intraoperative Care; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D018465:Molteno Implants; D010865:Pilot Projects; D011183:Postoperative Complications; D012086:Reoperation; D016896:Treatment Outcome
D016685:Mitomycin