title: The size of subconjunctival preparation does not influence the outcome of trabeculectomy with mitomycin C.
abstract: OBJECTIVE
  To compare the outcome of fornix-based trabeculectomy with mitomycin C (MMC) using 2 different sizes of subconjunctival preparation (36 mm² compared with 72 mm²).
  
  
  METHODS
  Prospective, randomized interventional case series.
  
  
  METHODS
  Patients 18 to 85 years of age with open-angle glaucoma and progressive visual field defects under maximum tolerated medical therapy were randomized to undergo initial fornix-based trabeculectomy with MMC (0.2 mg/mL for 5 min) with subconjunctival preparation of 6×6 mm (group A) or 8×9 mm (group B). Main outcome parameters were: intraocular pressure (IOP), best-corrected visual acuity (BCVA), number of 5-fluorouracil (5-FU) injections, and laser suturolyses (SL).
  
  
  RESULTS
  Twenty-eight eyes of 26 patients were enrolled, including 14 eyes in group A and 14 in group B. At 12 months, IOP (mean±SD) was 9.69±2.5 mm Hg in group A and 9.93±3.2 mm Hg in group B (P=0.17) without glaucoma medication. Mean BCVA (logMAR) at month 12 was 0.29±0.26 in group A and 0.26±0.2 in group B (P=0.71). Patients required 3.0 5-FU in group A and 4.1±2.9 5-FU in group B (P=0.16); 1.3±1.1 SL and 1.8±1.1 SL, respectively (P=0.23). We noted 2 cases of intraocular hypotony in the 6×6 mm group (14.3%) and 1 in the 8×9 mm group (7.1%).
  
  
  CONCLUSIONS
  There were no significant differences between study groups in mean IOP reduction, change in BCVA, or number of applied 5-FU and SL at 1-year follow-up. The area of subconjunctival preparation is only one of several factors playing a role in the outcome of trabeculectomy with MMC.
authors.affiliation: Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
authors.forename: Joanna
authors.initials: J
authors.lastname: Wasielica-Poslednik
authors.forename: Esther M
authors.initials: EM
authors.lastname: Hoffmann
authors.forename: Daniel
authors.initials: D
authors.lastname: Herzog
authors.forename: Shakhsanam
authors.initials: S
authors.lastname: Aliyeva
authors.forename: Julia
authors.initials: J
authors.lastname: Lamparter
authors.forename: Norbert
authors.initials: N
authors.lastname: Pfeiffer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000477:Alkylating Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D003228:Conjunctiva / Q000187:drug effects*; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D011183:Postoperative Complications; D011446:Prospective Studies; D014065:Tonometry, Ocular; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin; D005472:Fluorouracil