Molteno implant with mitomycin C: intermediate-term results.
OBJECTIVE
The authors examine the intermediate-term effects of adjunctive intraoperative mitomycin C (MMC) in a cohort of patients who received double-plate Molteno implants for complicated glaucomas.


METHODS
A consecutive series of 21 patients who received MMC 0.5 mg/ml for 5 minutes as an adjunct to a double-plate Molteno implant was compared by life-table analysis to a historical control group of 18 patients who received either no adjunct or 5-fluorouracil (5-FU) but no MMC.


RESULTS
At three years follow-up, 35% (95% confidence interval (CI), 15-57%) of patients who received MMC avoided failure criteria of intraocular pressure (IOP) less than 6 mm Hg or more than 21 mm Hg, addition of glaucoma medication, reoperation for glaucoma, or tube removal. Seventeen percent (95% CI, 4-37%) of patients in the control group at three years follow-up met similar criteria (p = 0.039). No late complications of tube erosion were seen in the MMC group.


CONCLUSIONS
Intraoperative MMC offers an increased likelihood of a two- to three-year period of medication-free IOP control in patients undergoing double-plate Molteno implants, compared to similar patients receiving 5-FU or no adjunctive antimetabolite therapy.
Perkins
T W
TW
Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison 53705-3631, USA.
Gangnon
R
R
Ladd
W
W
Kaufman
P L
PL
Libby
C M
CM
D000328:Adult; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D018463:Filtering Surgery / Q000295:instrumentation*; D005500:Follow-Up Studies; D005901:Glaucoma / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D018465:Molteno Implants; D009883:Ophthalmic Solutions; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome
D009883:Ophthalmic Solutions; D016685:Mitomycin