Subconjunctival versus intrascleral mitomycin-C in trabeculectomy.
OBJECTIVE
A randomized prospective comparison of sub-Tenon's administration of mitomycin-C (MMC) with intrascleral administration of MMC in trabeculectomy was performed to determine whether intrascleral application is superior to the standard sub-Tenon's application.


METHODS
Twenty-four eyes of 23 patients were randomized to treatment with MMC (0.27 mg/ml for 5 minutes). The route of administration was subconjunctival in group A and intrascleral in group B. Preoperative and postoperative visual acuity (VA), intraocular pressure (IOP), number of medications, and complications were compared between the two groups.


RESULTS
There was no statistically significant difference between the two groups preoperatively regarding VA, IOP, and number of medications. Postoperatively, IOP and number of medications required had decreased significantly in both groups. A significantly larger number of postoperative procedures were required in group B to control IOP (group A = 3, group B = 14, P = .002).


CONCLUSIONS
Both methods of MMC application significantly decreased the IOP and the number of medicines required to control IOP after trabeculectomy. The intrascleral use of MMC resulted in the need for more surgery postoperatively (P = .002).
Tressler
C S
CS
Sinai Hospital, Detroit, MI, USA.
Cyrlin
M N
MN
Rosenshein
J S
JS
Fazio
R
R
D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D003228:Conjunctiva; D004333:Drug Administration Routes; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D019384:Nucleic Acid Synthesis Inhibitors / Q000008:administration & dosage*; D009883:Ophthalmic Solutions; D011183:Postoperative Complications / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control*; D011446:Prospective Studies; D012590:Sclera; D014130:Trabeculectomy / Q000379:methods*; D014792:Visual Acuity
D019384:Nucleic Acid Synthesis Inhibitors; D009883:Ophthalmic Solutions; D016685:Mitomycin