Postoperative application of mitomycin c improves the complete success rate of primary trabeculectomy: a prospective, randomized trial

The intraoperative application of mitomycin c for primary trabeculectomy is associated with potentially sight-threatening side-effects. This study was performed to evaluate the pressure-lowering effect of postoperative application of mitomycin c for primary trabeculectomy and to evaluate the complic...

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Bibliographic Details
Published in:Graefe's archive for clinical and experimental ophthalmology 2006-11, Vol.244 (11), p.1429-1436
Main Authors: Mietz, Holger, Krieglstein, Günter K
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Alkylating Agents - administration & dosage
Female
Fibrosis - prevention & control
Follow-Up Studies
Glaucoma - surgery
Humans
Intraocular Pressure
Male
Middle Aged
Mitomycin - administration & dosage
Ophthalmology
Postoperative Care - methods
Prospective Studies
Sclera - drug effects
Trabeculectomy
Treatment Outcome
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Summary:The intraoperative application of mitomycin c for primary trabeculectomy is associated with potentially sight-threatening side-effects. This study was performed to evaluate the pressure-lowering effect of postoperative application of mitomycin c for primary trabeculectomy and to evaluate the complications of this new technique. A randomized, prospective clinical trial with 52 consecutive patients scheduled for glaucoma surgery in one large surgical center was performed. Patients underwent routine trabeculectomy. In group 1, mitomycin c (0.05 mg/ml) was applied topically to the filtering bleb for 5 min on the 3 days after surgery (postoperative application). In group 2, no mitomycin c was applied (controls). The IOP values, visual acuity, number of antiglaucomatous medications and complications were evaluated. Follow-up was evaluated up to 24 months for all patients. The mean intraocular pressure decreased from 31.1 to 15.4 mmHg in group 1 and from 24.8 to 15.6 mmHg in group 2 (P=0.79; t-test). The average number of medications decreased from 2.5 and 2.4 to 0.4 and 0.6 (P=0.53; t-test) in groups 1 and 2, respectively. No cases of hypotony maculopathy occurred. An individual decrease of more than 25% of the IOP was present in 84.6% in group 1 and in 53.8% in group 2 (P
ISSN:0721-832X
1435-702X
DOI:10.1007/s00417-005-0217-y