Trabeculectomy with mitomycin C versus trabeculectomy alone for juvenile primary open-angle glaucoma.
OBJECTIVE
We compare the intermediate-term outcome of initial trabeculectomy with adjunctive mitomycin C use versus initial trabeculectomy alone for juvenile primary open-angle glaucoma.


METHODS
This retrospective consecutive analysis included 44 eyes from 36 patients with juvenile primary-open angle glaucoma, all of whom underwent either initial trabeculectomy with adjunctive mitomycin C use (15 eyes) or initial trabeculectomy alone without mitomycin C use (29 eyes). We compared the success rate and complications between the two groups in a three-year follow-up period following surgery.


RESULTS
Three years subsequent to surgery, the cumulative success probability was 73% for the mitomycin C group and 68% for the control group, there being no real difference between the two groups (p = 0.89). A greater incidence of hypotony maculopathy was found amongst the mitomycin C group than was the case for the control group (20 versus 0%, respectively, p = 0.034). A lower intraocular pressure amongst the mitomycin C group was noted as compared with the control group (10.8 +/- 3.0 versus 13.3 +/- 3.8 mm Hg, respectively, p = 0.017) amongst the successfully treated patients.


CONCLUSIONS
Despite the lower intraocular pressure level for the successfully treated patients from the trabeculectomy with mitomycin C group, and a greater incidence of resultant hypotony maculopathy for this group as compared with the trabeculectomy alone group, there appeared to be no significant difference in the cumulative success probability for this group as compared with the trabeculectomy alone group. Therefore, we caution against the use of an initial trabeculectomy with mitomycin C for juvenile primary open-angle glaucoma.
Tsai
Jen-Chia
JC
Department of Ophthalmology, Chang Gung Memorial Hospital, Kaohsiung, Taiwain, ROC. tsai4118@ms26.hinet.net
Chang
Hsueh-Wen
HW
Kao
Chien-Neng
CN
Lai
Ing-Chou
IC
Teng
Mei-Ching
MC
D000293:Adolescent; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use*; D011183:Postoperative Complications; D012189:Retrospective Studies; D014130:Trabeculectomy; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin