The effect of mitomycin C on Molteno implant surgery: a 1-year randomized, masked, prospective study.
OBJECTIVE
The authors assess whether adjunctive mitomycin C improves Molteno tube shunt surgery in terms of intraocular pressure (IOP), visual acuity, and complication rates.


METHODS
Twenty-five eyes of twenty-five consecutive patients undergoing double-plate Molteno implant surgery were randomized to receive either mitomycin C (MMC) 0.4 mg/mL for 2 minutes or a control balanced salt solution in a masked, prospective study. Intraocular pressure, visual acuity, and complications were recorded 1 week and 1, 3, 6, and 12 months after surgery. A repeated measures analysis of variance (ANOVA) model was used to test the overall effect of the drug on IOP and percent change from preoperative IOP.


RESULTS
Thirteen eyes received balanced salt solution and 12 eyes received MMC. There was no difference between the groups with respect to age, preoperative IOP, log mean angle of resolution (LogMar) visual acuity, or number of preoperative medications. Except for week 1, there were no differences between the groups at any of the clinic visits with respect to IOP and percent change from baseline IOP. Analysis of the visual acuity (LogMar) showed reduction in vision for both groups. Complications were similar in each group, as were number of postoperative hypotensive agents required.


CONCLUSIONS
Adjunct MMC does not demonstrate a significant difference in outcomes compared with placebo in pressure-ridged Molteno implant surgery. Results of this study are limited by a small number of patients in each group and a fixed dose of MMC.
Department of Ophthalmology, Indiana University, Indianapolis 46202, USA.
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L
Cantor
J
J
Burgoyne
S
S
Sanders
V
V
Bhavnani
J
J
Hoop
E
E
Brizendine
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D005901:Glaucoma / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D018465:Molteno Implants; D019384:Nucleic Acid Synthesis Inhibitors / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D014792:Visual Acuity / Q000187:drug effects
D019384:Nucleic Acid Synthesis Inhibitors; D016685:Mitomycin