title: Simultaneous subconjunctival and subscleral mitomycin-C application in trabeculectomy.
abstract: OBJECTIVE
  To establish the efficacy and safety of simultaneous subconjunctival and subscleral application of mitomycin-C in trabeculectomy.
  
  
  METHODS
  A prospective, randomized study.
  
  
  METHODS
  Sixty-eight patients (68 eyes) with refractory glaucomas were included in the study.
  
  
  METHODS
  Eyes were randomly assigned to receive intraoperative mitomycin-C (0.3 mg/ml) applied under the conjunctival flap (group 1), scleral flap (group 2), or under both flaps (group 3).
  
  
  METHODS
  Mean intraocular pressure (IOP), postoperative medications, visual acuity, filtering bleb appearance, and complications.
  
  
  RESULTS
  There was a significant difference in IOP at 6, 9, and 12 months after surgery among the three groups (P = 0.021, 0.026, and 0.033, respectively ANOVA). At 12 months, the mean IOP in group 3 was 9.8+/-3.7 mm Hg compared with 13.4+/-5.5 mm Hg in group 2. (P = 0.015) and 12.4+/-4.4 mm Hg in group 1 (P = 0.039). Success rate (21 mm Hg or less), number of antiglaucoma medications, and complications showed no statistical significant difference between the three groups at each postoperative visit.
  
  
  CONCLUSIONS
  Mitomycin-C applied under the scleral flap may have an additional beneficial effect when combined with simultaneous subconjunctival exposure.
authors.affiliation: El-Maghraby Eye Hospital, Jeddah, Saudi Arabia.
authors.forename: F
authors.initials: F
authors.lastname: El Sayyad
authors.forename: M
authors.initials: M
authors.lastname: Belmekki
authors.forename: M
authors.initials: M
authors.lastname: Helal
authors.forename: M
authors.initials: M
authors.lastname: Khalil
authors.forename: H
authors.initials: H
authors.lastname: El-Hamzawey
authors.forename: M
authors.initials: M
authors.lastname: Hisham
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000187:drug effects*; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D011446:Prospective Studies; D012449:Safety; D012590:Sclera / Q000187:drug effects*; D014130:Trabeculectomy; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin