title: Intraoperative mitomycin-C without conjunctival and Tenon's capsule touch in primary trabeculectomy.
abstract: 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.
authors.affiliation: Department of Ophthalmology, Glaucoma Service, University of São Paulo, São Paulo, Brazil. rsusana@originet.com.br
authors.forename: R
authors.initials: R
authors.lastname: Susanna
authors.forename: V P
authors.initials: VP
authors.lastname: Costa
authors.forename: R F
authors.initials: RF
authors.lastname: Malta
authors.forename: W L
authors.initials: WL
authors.lastname: Barboza
authors.forename: J P
authors.initials: JP
authors.lastname: Vasconcellos
mesh_terms: 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
chemical_list: D009883:Ophthalmic Solutions; D016685:Mitomycin