Intraoperative mitomycin-C without conjunctival and Tenon's capsule touch in primary trabeculectomy.
OBJECTIVE
To verify whether intraoperative mitomycin C (MMC) without conjunctival and Tenon's touch is effective in inhibiting the development of thin, avascular blebs in eyes undergoing primary trabeculectomy.


METHODS
Noncomparative, interventional study.


METHODS
Fifteen eyes of 15 consecutive patients undergoing primary trabeculectomy.


METHODS
All eyes underwent trabeculectomy with intraoperative MMC (0.25 mg/ml for 3 minutes) without either conjunctival or Tenon's touch. Patients were examined 1 month, 3 months, 6 months, and 12 months after surgery. Intraocular pressure (IOP) and number of medications were evaluated at each examination. The appearance of the bleb was classified at the last examination into one of three groups: flat and vascularized; elevated but not avascular; or elevated, thin, and avascular.


METHODS
Intraocular pressure, number of antiglaucoma medications, and appearance of the bleb.


RESULTS
Preoperative mean IOP was 30.57 +/- 10.92 mmHG: Statistically significant IOP reductions were observed 1 month, 3 months, 6 months, and 1 year after surgery (P < 0.01). Twelve months after surgery, the mean IOP was 14.92 +/- 6.53 mmHG: Five eyes (33.3%) showed an IOP less than 15 mmHg without antiglaucoma medication at the 12-month examination. The bleb was considered elevated, thin, and avascular in 12 of 15 eyes (80%) at the end of follow-up.


CONCLUSIONS
Intraoperative MMC at 0.25 mg/ml for 3 minutes without either conjunctival or Tenon's touch was not effective in eliminating the development of thin, avascular blebs in eyes undergoing primary trabeculectomy.
Susanna
R
R
Department of Ophthalmology, Glaucoma Service, University of São Paulo, São Paulo, Brazil. rsusana@originet.com.br
Costa
V P
VP
Malta
R F
RF
Barboza
W L
WL
Vasconcellos
J P
JP
D003228:Conjunctiva / Q000033:anatomy & histology; D003238:Connective Tissue / Q000033:anatomy & histology; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009883:Ophthalmic Solutions; D011183:Postoperative Complications / Q000517:prevention & control*; D013524:Surgical Flaps; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity; D014945:Wound Healing / Q000187:drug effects
D009883:Ophthalmic Solutions; D016685:Mitomycin