title: Efficacy and safety of mitomycin-C in primary trabeculectomy: five-year follow-up.
abstract: OBJECTIVE
  To examine the 5-year complications and results of primary trabeculectomy with mitomycin-C (MMC).
  
  
  METHODS
  Retrospective, noncomparative interventional case series.
  
  
  METHODS
  One hundred twenty-three eyes that underwent primary trabeculectomy with MMC between December 1991 and March 1995.
  
  
  METHODS
  All patients received standard trabeculectomy performed by one of two surgeons, using a Weck cell-soaked pledget of MMC, 0.25, 0.33, or 0.5 mg/ml, for 0.5 to 5 minutes. Laser suture lysis was performed postoperatively for intraocular pressure control.
  
  
  METHODS
  The incidence of complications, including hypotony with or without maculopathy, bleb leak or blebitis, pressure control, and medication reduction at yearly intervals.
  
  
  RESULTS
  Mean preoperative and year 5 postoperative intraocular pressures (IOP) were 25.79 and 9.91 mmHg (P < 0.05, paired t test). Hypotony (IOP < 6) occurred in 42.2% of eyes after a mean follow-up of 26.1 months. Hypotony maculopathy occurred in 8.9% of eyes at mean follow-up of 33.7 months. Bleb leak occurred in 14.6% of eyes at a mean follow-up of 27.9 months. Blebitis occurred in 5.7% of eyes at a mean follow-up of 35.4 months, and endophthalmitis occurred in 0.8% of eyes at 15 months; 14.9% of eyes lost 4 lines of visual acuity. The single predictor for the development of late-term hypotony was IOP 1 month after operation (P < 0.05).
  
  
  CONCLUSIONS
  Primary mitomycin trabeculectomy significantly lowers IOP at 5 years but is associated with a high incidence of delayed hypotony.
authors.affiliation: Department of Ophthalmology, Allegheny General Hospital, 420 East North Avenue, Pittsburgh, PA 15212, USA.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Bindlish
authors.forename: Garry P
authors.initials: GP
authors.lastname: Condon
authors.forename: James D
authors.initials: JD
authors.lastname: Schlosser
authors.forename: Joyce
authors.initials: J
authors.lastname: D'Antonio
authors.forename: Karen B
authors.initials: KB
authors.lastname: Lauer
authors.forename: Richard
authors.initials: R
authors.lastname: Lehrer
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D015812:Glaucoma, Angle-Closure / Q000188:drug therapy / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012449:Safety; D012590:Sclera / Q000187:drug effects*; D013997:Time Factors; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin