Trabeculectomy with mitomycin C: intermediate-term results.
OBJECTIVE
This study was performed to provide results 2 to 3 years after trabeculectomy with mitomycin C (MMC).


METHODS
A consecutive series of all 68 patients who underwent trabeculectomy with MMC was analyzed using Kaplan-Meier life-table statistics and compared with other published retrospective analyses.


RESULTS
At 2- and 3-year follow-up examinations, 59% (95% confidence interval [CI], 44-70%) and 47% (95% CI, 32-61%) of patients, respectively, avoided an intraocular pressure (IOP) of more than 21 mmHg or less than 20% below their preoperative level without glaucoma medication on two consecutive occasions more than 1 month apart after 3 months follow-up (75% [95% CI, 60-84%] and 70% [95% CI, 53-81%], respectively, with medication) and avoided additional glaucoma surgery. Loss of more than three lines of visual acuity on two occasions more than 1 month apart after 3 months follow-up occurred in 28% of patients (> 2 lines in 44%) at 3 years. Nonreversible causes of loss of three lines of acuity occurred in 13% of patients. Complications requiring reoperation occurred in 16% of patients and included hypotony maculopathy (4%) and late bleb leaks (4%).


CONCLUSIONS
At the 3-year follow-up evaluation, trabeculectomy with MMC provided an approximately 50% chance of maintaining IOPs less than 21 mmHg and a more than 20% IOP reduction without concomitant use of glaucoma medication, which increased to 70% with the addition of medication. This procedure was associated with an approximately 30% risk of substantial visual loss (approximately 15% nonreversible) and a 15% chance of reoperation for complications.
Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, USA.
T W
TW
Perkins
R
R
Gangnon
W
W
Ladd
P L
PL
Kaufman
G A
GA
Heatley
D000328:Adult; D000368:Aged; D005260:Female; D005901:Glaucoma / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis; D014130:Trabeculectomy; D014792:Visual Acuity / Q000502:physiology
D016685:Mitomycin