title: Outcomes of primary phakic trabeculectomies without versus with 0.5- to 1-minute versus 3- to 5-minute mitomycin C.
abstract: OBJECTIVE
  To compare the intraocular pressure and hypotony outcomes of primary phakic trabeculectomies with no mitomycin C (MMC), shorter MMC, and longer MMC exposure.
  
  
  METHODS
  We evaluated primary phakic trabeculectomies with no MMC (36 eyes of 36 patients), 0.5- to 1-minute MMC (50 eyes of 50 patients), and 3- to 5-minute MMC (38 eyes of 38 patients) at the concentration of 0.5 mg/ml. Successful trabeculectomy was defined as an intraocular pressure of 21 mm Hg or less without development of a marked visual acuity loss associated with prolonged hypotony (intraocular pressure < 6 mm Hg over 3 months) and without the need for additional surgery to control intraocular pressure or treat postoperative complications.
  
  
  RESULTS
  The three groups were similar in demographics, preoperative intraocular pressure, and medical dependency. However, the incidence of hypotony during the postoperative periods of 3 to 12 months was significantly higher in the 3- to 5-minute MMC group (P < .05, chi-square test). Severe visual acuity loss associated with hypotony was also more frequently found in the 3- to 5-minute MMC group than in the 0.5- to 1-minute (P = .009, chi-square test) group or the control group (P = .014, chi-square test). In addition, the success probabilities were significantly different among the three groups (P = .001, Kaplan-Meier survival analysis with log-rank test) and were the highest in the 0.5- to 1-minute MMC group and the lowest in the 3- to 5-minute MMC group.
  
  
  CONCLUSIONS
  Shorter application (0.5 to 1 minute) of MMC appears to be optimal for the successful outcome of primary phakic trabeculectomy compared with no MMC or longer application of MMC at a concentration of 0.5 mg/ml.
authors.affiliation: Kresge Eye Institute and Wayne State University School of Medicine, Detroit, Michigan 48201-1423, USA.
authors.forename: Y Y
authors.initials: YY
authors.lastname: Kim
authors.forename: R M
authors.initials: RM
authors.lastname: Sexton
authors.forename: D H
authors.initials: DH
authors.lastname: Shin
authors.forename: C
authors.initials: C
authors.lastname: Kim
authors.forename: S A
authors.initials: SA
authors.lastname: Ginde
authors.forename: J
authors.initials: J
authors.lastname: Ren
authors.forename: D
authors.initials: D
authors.lastname: Lee
authors.forename: T H
authors.initials: TH
authors.lastname: Kupin
mesh_terms: D000368:Aged; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D007908:Lens, Crystalline; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015814:Ocular Hypotension / Q000139:chemically induced; D011183:Postoperative Complications / Q000139:chemically induced; D013997:Time Factors; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014786:Vision Disorders / Q000139:chemically induced; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D016685:Mitomycin