Outcome of trabeculectomy with mitomycin-C in the iridocorneal endothelial syndrome.
OBJECTIVE
Eyes with iridocorneal endothelial (ICE) syndrome have a high risk of failure in glaucoma filtering surgery failing. We investigated the efficacy of trabeculectomy with intraoperative mitomycin-C application in these patients.


METHODS
Retrospective nonrandomized comparative trial with historical controls.


METHODS
Ten patients with unilateral iridocorneal endothelial (ICE) syndrome were reviewed. Their intraocular pressures could not be controlled medically. In five eyes, this was the primary surgery performed. Five of the patients had undergone prior intraocular pressure-(IOP) lowering surgery that had failed at the time enrolled. Results were compared with previously published case series of similar patients treated with trabeculectomy alone or trabeculectomy and subconjunctival 5-fluorouracil injections.


METHODS
Intervention consisted of trabeculectomy with a limbus-based conjunctival flap and mitomycin-C application. The dosage of mitomycin-C was 0.4 mg/ml for 1 to 4 minutes (mean, 1.9 min).


METHODS
Adequate control of IOP (without medication lower than 21 mm Hg).


RESULTS
In eight eyes the IOP remained well controlled (mean IOP, 12.1 mm Hg) over the entire length of available of follow-up (mean, 14.9 months). Two eyes required implantation of an aqueous tube shunt at 4 and 11 months, respectively, after trabeculectomy with mitomycin-C. One eye experienced visual loss of 3 Snellen lines because of hypotony maculopathy.


CONCLUSIONS
Trabeculectomy with mitomycin-C application offers a reasonable intermediate-term success rate in ICE patients, who are otherwise at high risk for failure of filtering surgery.
Lanzl
I M
IM
Augenklinik der Technischen Universität München, Germany.
Wilson
R P
RP
Dudley
D
D
Augsburger
J J
JJ
Aslanides
I M
IM
Spaeth
G L
GL
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003316:Corneal Diseases / Q000150:complications* / Q000473:pathology; D004728:Endothelium, Corneal / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure; D007499:Iris Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D012189:Retrospective Studies; D013577:Syndrome; D014130:Trabeculectomy; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin