title: Two-year outcome of repeat trabeculectomy with mitomycin C in primary open-angle and PEX glaucoma.
abstract: OBJECTIVE
  To evaluate the effectiveness of repeat trabeculectomy with risk factor-adjusted mitomycin C (MMC) application in primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEXG) over 2 years.
  
  
  METHODS
  A total of 58 patients (43 with POAG, 15 with PEXG) who had undergone repeat trabeculectomy with MMC were included in this retrospective study. Exposure time of MMC 0.3 mg/mL was adjusted according to a standardized protocol. Main outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP) reduction, surgical success rate (criteria were defined as A: IOP ≤21 mm Hg and a reduction of IOP ≥20%; B: IOP ≤18 mm Hg and a reduction of IOP of ≥30%; C: IOP ≤15 mm Hg and a reduction of IOP of ≥40% from baseline), and number of medications at baseline, 3 months, and 2 years postoperatively.
  
  
  RESULTS
  The BCVA remained stable for 2 years after surgery (0.47 ± 0.47 at baseline, 0.49 ± 0.64 logMAR units after 2 years, respectively). Mean IOP decreased from 22.2 ± 7.0 mm Hg at baseline to 12.7 ± 3.1 mm Hg at 3 months and 12.9 ± 4.3 mm Hg 2 years after surgery. The qualified success rate for criterion A was 75.4%, for criterion B 66.6%, and for criterion C45.6%. Complete success rates were 42.9%, 37.5%, and 32.1%, respectively. Two years after repeat trabeculectomy, the mean IOP was reduced by 38.8%, and the number of medications was reduced significantly.
  
  
  CONCLUSIONS
  Repeat trabeculectomy with MMC is successful at lowering IOP in POAG and PEXG and permits a significant and safe reduction of antiglaucomatous medication for at least 2 years after surgery.
authors.affiliation: Herzog Carl-Theodor Eye Clinic, Munich - Germany.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Meyer
authors.forename: Natascha E
authors.initials: NE
authors.lastname: Graf
authors.forename: Sebastian
authors.initials: S
authors.lastname: Philipp
authors.forename: Marie T
authors.initials: MT
authors.lastname: Fischer
authors.forename: Katharina
authors.initials: K
authors.lastname: Haller
authors.forename: Peter
authors.initials: P
authors.lastname: Distelmaier
authors.forename: Carl-Ludwig
authors.initials: CL
authors.lastname: Schönfeld
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000477:Alkylating Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D017889:Exfoliation Syndrome / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D012086:Reoperation; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000379:methods*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin