Trabeculectomy with mitomycin C for post-keratoplasty glaucoma.
OBJECTIVE
To investigate the effect of trabeculectomy with and without mitomycin C in post-keratoplasty glaucoma.


METHODS
A retrospective study was performed on patients who underwent trabeculectomy for glaucoma after penetrating keratoplasty. 34 eyes of 32 patients were included in this study. 26 eyes received trabeculectomy with mitomycin C and eight eyes without mitomycin C. The procedure was deemed successful if the intraocular pressure was maintained below 21 mm Hg with or without use of additional antiglaucoma medication (mean follow up time 22.3 (SD 10.3) months).


RESULTS
At the last examination trabeculectomy was successful in 19 of 26 eyes (73.0%) with mitomycin C (+) and two of eight (25.0%) without (p=0.0219). When the prognosis was analysed by Kaplan-Meier curve, the mitomycin C (+) group showed a better prognosis (p=0.0182). Mean intraocular pressure and average number of glaucoma medications improved in the group with mitomycin C without severe side effects on the graft. Graft rejection after trabeculectomy was seen in two eyes in the mitomycin C group. Final graft clarity rate was 69.2% (18/26) in the mitomycin C (+) group and 37.5% (3/8) in the mitomycin C (-) group. Complications such as persistent epithelial defect, cystoid macular oedema, choroidal detachment, leakage from bleb were seen in four eyes in the mitomycin C (+) group and in one eye in the mitomycin C (-) group.


CONCLUSIONS
Trabeculectomy with mitomycin C showed better results for glaucoma following keratoplasty.
Ishioka
M
M
Department of Ophthalmology, Tokyo Dental College, Japan.
Shimazaki
J
J
Yamagami
J
J
Fujishima
H
H
Shimmura
S
S
Tsubota
K
K
D000328:Adult; D000368:Aged; D005260:Female; D005901:Glaucoma / Q000150:complications / Q000209:etiology / Q000601:surgery*; D006084:Graft Rejection / Q000209:etiology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D019384:Nucleic Acid Synthesis Inhibitors / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000379:methods*; D017211:Treatment Failure; D014792:Visual Acuity / Q000502:physiology
D019384:Nucleic Acid Synthesis Inhibitors; D016685:Mitomycin