Trabeculectomy with brief exposure to mitomycin C.
BACKGROUND
To evaluate the safety and efficacy of primary trabeculectomy with brief exposure (15 s) to mitomycin C (MMC) (0.4 mg/mL).


METHODS
Medical record review of all patients who underwent primary trabeculectomy with brief exposure to MMC at the Goldschleger Eye Institute in a 4-year period was performed.


RESULTS
Sixty-three patients (35 men, mean age of 55 years) underwent trabeculectomy with brief exposure to MMC. Intraocular pressure (IOP) decreased a mean +/- standard deviation of 17.9 +/- 9.6 mmHg from 30.4 +/- 9.5 mmHg preoperatively to 12.5 +/- 6.2 mmHg postoperatively after a mean follow up of 18.3 months (P < 0.001). Number of antiglaucoma medications decreased from 2.9 +/- 1.1 preoperatively to 0.2 +/- 0.4 postoperatively (P < 0.001, paired samples t-test). Complete success, defined as IOP < 18 mmHg without antiglaucoma medication, was achieved in 46 patients (73%) and qualified success, defined as IOP <or= 21 mmHg with or without antiglaucoma medications, was achieved in 59 patients (93.7%). Thirty-eight patients (60%) had a final IOP < 15 mmHg with no glaucoma medications at the end of follow up. Needle revision was required in four patients (6.3%) and repeated trabeculectomy was performed in three patients (4.8%). Four patients had an IOP of less than 6 mmHg at the end of follow-up period (three had final IOP of 5 mmHg and one of 4 mmHg); these patients had an average larger bleb size (2.8 +/- 1.3).


CONCLUSIONS
Trabeculectomy with brief (15 s) exposure to MMC 0.4 mg/mL is safe and effective in lowering IOP in this group of patients, and results in low rate of postoperative complications. Success is comparable to reported data with longer exposure durations to antimetabolites.
Ben Simon
Guy J
GJ
The Goldschleger Eye Institute, Sheba Medical Center, Sackler School of Medicine at Tel Aviv University, Tel Aviv, Israel. guybensimon@gmail.com
Glovinsky
Yoseph
Y
D000477:Alkylating Agents / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005901:Glaucoma / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome
D000477:Alkylating Agents; D000959:Antihypertensive Agents; D016685:Mitomycin