title: Outcome of trabeculectomy with mitomycin C in patients with advanced glaucoma.
abstract: OBJECTIVE
  To determine the medium-term intraocular pressure (IOP) control and visual outcomes for patients with advanced glaucoma undergoing trabeculectomy with mitomycin C.
  
  
  METHODS
  All patients with advanced glaucoma (MD -20 dB or above) undergoing trabeculectomy with mitomycin C between 2000 and 2008 under the care of a single glaucoma surgeon were included. IOP, visual acuity and visual field outcomes were assessed from data prospectively collected into a surgical outcome database.
  
  
  RESULTS
  103 patients were eligible for inclusion. The post-trabeculectomy group mean IOP varied between 11.3 and 13.3 mm Hg between 1 and 7 years. At year 5, 85.2% had an IOP of <16 mm Hg, and 96.3% had an IOP of < 21 mm Hg. The number completing a reliable visual-field exam decreased significantly year on year, but the change in mean MD for the group as a whole and for individual patients remained stable. 28 patients experienced a significant reduction in acuity defined as two or more lines of Snellen, although this was not due to glaucoma surgery in the majority. The only preoperative determinant for a significant reduction in VA was the preoperative MD (-27.00 dB (n=21) compared with -24.79 dB (n=63; p=0.029)).
  
  
  CONCLUSIONS
  Trabeculectomy is a successsful method of controlling IOP in the short to medium term in patients with advanced glaucoma.
authors.affiliation: Department of Ophthalmology, Nottingham University NHS Trust, Queen's Medical Centre, Nottingham NG7 2UH, UK.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Stead
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: King
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy / Q000379:methods; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D005260:Female; D005901:Glaucoma / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects* / Q000502:physiology; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D009883:Ophthalmic Solutions; D016685:Mitomycin