Purified triamcinolone acetonide as antifibrotic adjunct in glaucoma filtering surgery.
BACKGROUND
The purpose of this study is to compare the effects of mitomycin C (MMC) and triamcinolone acetonide (TAC) during and after glaucoma filtering surgery.


METHODS
Retrospective interventional consecutive case series. All eyes underwent primary guarded trabeculectomy with either MMC or sub-Tenon TAC injection. Intraoperative and postoperative complications up to 5 years after the filtering surgery were evaluated. Differences between the two regimens were tested for statistical significance.


RESULTS
A total of 64 trabeculectomies, of which 39 with MMC and 25 with TAC, were compared. At the 5-year follow-up examination three of the eyes treated with MMC (7.7 %) and none of the eyes treated with TAC had an intraocular pressure of more than 18 mmHg (p = 0.08). In the MMC group, three eyes required repeated glaucoma surgery (7.7 %; one trabeculectomy, one Baerveldt drainage implant, one cyclodiode laser treatment), while this was two eyes in the TAC group (8.0 %; one Baerveldt drainage implant, one cyclodiode laser treatment) (p = 0.97).


CONCLUSIONS
The present study demonstrates that in primary trabeculectomy, the 5-year risk profiles of MMC and purified TAC are comparable, suggesting that as an antifibrotic agent TAC is at least as effective as MMC. Prospective randomized trials will need to confirm the agents' relative long-term benefits.
Department of Ophthalmology, Medical Centre Haaglanden, Lijnbaan 32, 2512 VA The Hague, the Netherlands. f.hogewind@mchaaglanden.nl
Barend Frits Theodorus
BF
Hogewind
Benjamin
B
Pijl
Carel Benedict
CB
Hoyng
Thomas
T
Theelen
D000368:Aged; D000477:Alkylating Agents / Q000008:administration & dosage; D003228:Conjunctiva / Q000187:drug effects* / Q000473:pathology; D005260:Female; D005355:Fibrosis / Q000188:drug therapy / Q000473:pathology; D015812:Glaucoma, Angle-Closure / Q000601:surgery*; D005902:Glaucoma, Open-Angle / Q000601:surgery*; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007431:Intraoperative Complications; D008297:Male; D016685:Mitomycin / Q000008:administration & dosage*; D011183:Postoperative Complications; D012189:Retrospective Studies; D058475:Tenon Capsule / Q000187:drug effects; D014065:Tonometry, Ocular; D014130:Trabeculectomy; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity / Q000502:physiology
D000477:Alkylating Agents; D005938:Glucocorticoids; D016685:Mitomycin; D014222:Triamcinolone Acetonide