title: Mitomycin-C-augmented trabeculectomy for neovascular glaucoma. A preliminary report.
abstract: OBJECTIVE
  This study aimed to investigate the safety and efficacy of trabeculectomy with intraoperative mitomycin C (MMC) in the management of eyes with neovascular glaucoma (NVG).
  
  
  METHODS
  Fifteen eyes of 14 patients with NVG were included in the study. NVG was secondary to central retinal vein occlusion (3 eyes), hemiretinal vein occlusion (2 eyes), proliferative diabetic retinopathy (8 eyes), branch retinal vein occlusion (1 eye) and idiopathic (1 eye). Preoperative retinal ablation was performed in eyes with evidence of posterior segment ischaemia. Following this, all eyes underwent trabeculectomy with intraoperative MMC (0.4 mg/ml for 3 minutes). Clinical outcome assessment included visual acuity, intraocular pressure (IOP), bleb appearance, identification of complications and antiglaucoma medications required to control IOP.
  
  
  RESULTS
  The mean IOP decreased from 38.6 +/- 12.9 mmHg (range, 15-64 mmHg) to 17.4 +/- 9.33 mmHg (range, 4-34 mmHg) (P = 0.001). Preoperative visual acuity ranged from light perception to 6/9 in the affected eye. Thirteen (86.6%) of 15 eyes improved vision or retained preoperative vision, one (6.7%) eye lost light perception and one (6.7%) eye developed tractional retinal detachment two years after trabeculectomy. Ten (66.7%) of 15 eyes were classified as surgical success with a mean follow-up of 28.6 +/- 26.3 months (range, 2-82 months). None of the patients developed choroidal haemorrhage, hypotony maculopathy, late onset bleb leak or endophthalmitis.
  
  
  CONCLUSIONS
  Trabeculectomy with intraoperative MMC is a good treatment modality in the management of eyes with NVG.
authors.affiliation: VST Centre for Glaucoma Care, L V Prasad Eye Institute, L V Prasad Marg, Banjara Hills, Hyderabad 500 034, India. mandal@lvpeye.stph.net
authors.forename: Anil K
authors.initials: AK
authors.lastname: Mandal
authors.forename: Ajit B
authors.initials: AB
authors.lastname: Majji
authors.forename: Soma P
authors.initials: SP
authors.lastname: Mandal
authors.forename: Taraprasad
authors.initials: T
authors.lastname: Das
authors.forename: Subhadra
authors.initials: S
authors.lastname: Jalali
authors.forename: Vijaya K
authors.initials: VK
authors.lastname: Gothwal
authors.forename: Sunil S
authors.initials: SS
authors.lastname: Jain
authors.forename: Rishita
authors.initials: R
authors.lastname: Nutheti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D005260:Female; D015355:Glaucoma, Neovascular / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D010865:Pilot Projects; D011183:Postoperative Complications; D011446:Prospective Studies; D012449:Safety; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin