Trabeculectomy with Mitomycin C in Refractory GIaucoma

Ngamkae Roengvoravate M.D.
Department of Ophthalmology, Siriraj Hospital, Mahidol University, Bangkok Thailand.


ABSTRACT

The use of intraoperative application of mitomycin C at the filtration site has been effective in eyes at increased risk for failure of routine trabeculectomy.

To study the efficacy and safety of this technique in patients with refractory glaucoma, a prospective study was performed on 26 eyes of 18 consecutive patients. A single 3-minute of 0.4 mg/ml mitomycin C was applied between Tenon's capsule and the sclera before trabeculectomy. The mean preoperative intraocular pressure was 28 mmlHg. Postoperative intraocular pressure control was achieved in 71.4% of patients as defined by an intraocular pressure of less than 21 mmHg without additional glaucoma medication.

Although mitomycin C is highly successful in controlling intraocular pressure in refractory glaucoma, further study is required to determine the long term complications and establish the optimum protocol for the use of this drug as an adjunct to trabeculectomy.