Trabeculectomy with Adjunctive Mitomycin-C: Compariative Study of Subconjunctival Injection and Soaking of Mitomycin-C (I)

Lee, Sang Hyup; Kim, Cheol Min

Abstract

We conducted retrospective study to compare MMC subconjunctival injection with MMC soaking for surgical outcome and postoperative complications as an adjunct to trabeculectomy in eyes with primary glaucoma. Thirty-two eyes of 27 patients with primary glaucoma who ahd undergone primary trabeculectomy with adjunctive subconjunctival mitomycin-C injection (Group I, 0.04mg/ml, 0.05ml) were compared with subconjunctival mitomycin-C soaking group (Group II, 0.4mg/ml, 3 min) of 30 eyes of 25 patietns with primary glaucoma who had undergone primary trabeculectomy. Minimal follow-up period was 3 months and mean follow-up period was 14.5 months in group I, 15.7 months in group II. Preoperative mean IOP was 33.9+/-9.3mmHg in group I, 28.3+/-10.1mmHg in group II and there was no statistical significance. Postoperative mean IOP in 1, 3, 5 months were 16.4+/-7.0, 16.1+/-7.5, 16.9+/-5.8mmHg in group I, 13.2+/-4.4, 14.2+/-4.1, 15.1+/-4.7 mmHg in group II, respectively. Twenty-six eyes(81%) in group I and twenty-three eyes (77%) in group II achieved an intraocular pressure of less than 21 mmHg and good bleb formation. Postoperative complications were hyphema(9% in group I, 10% in group II), shallow anterior chamber (6% in group I, 3% in group II), bleb leaking (3% in group I, 0% in group II), hypotony maculopathy (3% in group I, 3% in group II), avascular cystic bleb(13% in group I, 25% in group II) and belb fibrosis (18% in group I, 25% in group II). There was no statistical significance. The rates of surgical success and postoperative compliations were similar in the two groups. Subconjunctival injection is another useful adjunctive application method of MMC. The method is able to control accurate amount and to improve surgical outcome in trabeculectomy.