title: [Application of mitomycin in primary covered sclerotomy].
abstract: BACKGROUND
  The covered sclerotomy is a minimally invasive, standardized fistulating glaucoma surgical procedure with reduced risk of complications. Early postoperative bleb fibrosis is a main success-limiting problem. In this clinical study IOP follow-up and the one year success rate after primary application of mitomycin C (MMC) is analyzed.
  
  
  METHODS
  In 76 eyes with advanced glaucoma and without previous fistulating surgery, a covered sclerotomy combined with 3-minute-application of MMC0,02 % was performed. Over a period of 12 months, bleb and pressure were controlled regularly. The success rates were compared primarily with data from an earlier study without application of MMC.
  
  
  RESULTS
  The mean age of the patients was 70 ± 11 years. 45 % had a pseudoexfoliation syndrome while 41 % were pseudophakic. The mean intraocular pressure (IOP) was 27 ± 8,5 mmHg preoperatively. After 12 months it was 16,2 ± 4,3 mmHg (p < 0.05) with a mean IOP reduction of 40 %. The absolute success rate (intraocular pressure < 21 mmHg without antiglaucoma therapy) was 58 % and the relative success rate (intraocular pressure < 21 mmHg under treatment) was 71 %. A revision or a needling was performed in 22 eyes (29 %). MMC-related complications were not observed.
  
  
  CONCLUSIONS
  Through the additional MMC application on the base of the primary covered sclerotomy a significant pressure reduction could be achieved. 58 % of the patients didn't need any glaucoma medicine. The absolute success rate was higher than without additional inhibitions of the fibrosis.
authors.affiliation: Klinik für Augenheilkunde, Vivantes Klinikum Neukölln, Berlin.
authors.forename: E
authors.initials: E
authors.lastname: Karioris
authors.affiliation: Augenklinik Berlin-Marzahn.
authors.forename: C
authors.initials: C
authors.lastname: Wirbelauer
authors.affiliation: Klinik für Augenheilkunde, Vivantes Klinikum Neukölln, Berlin.
authors.forename: H
authors.initials: H
authors.lastname: Häberle
authors.affiliation: Klinik für Augenheilkunde, Vivantes Klinikum Neukölln, Berlin.
authors.forename: D T
authors.initials: DT
authors.lastname: Pham
mesh_terms: D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D016685:Mitomycin / Q000008:administration & dosage*; D011292:Premedication / Q000379:methods*; D015422:Scleral Diseases / Q000209:etiology* / Q000517:prevention & control*; D012599:Sclerostomy / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome
chemical_list: D016685:Mitomycin