Our results of large area mitomycin C application trabeculectomy in cases with advanced glaucoma

• Main Authors: Mutlu Cihan Dağlıoğlu, Esra Ayhan Tuzcu, Nilüfer İlhan, Mesut Coşkun, Emre Ayıntap, Uğurcan Keskin, Özgür İlhan, Hilal Kahraman
• Format: Article
• Language: English
• Published: Dicle University Medical School 2013-12-01
• Series: Dicle Medical Journal
• Subjects: Mitomycin-C; trabeculectomy; bleb
• Online Access: http://www.diclemedj.org/upload/sayi/29/Dicle%20Med%20J-01833.pdf

Objective: To evaluate large area Mitomycin-C (MMC)applied trabeculectomy results in advanced glaucomapatients in which targeted intraocular pressure (IOP) cannot be achieved with maximum medical therapy.Methods: 41 eyes of 35 advanced glaucoma patientsthat can not be controlled with medical treatment were includedto the study. Large area MMC application was appliedfor 2 minutes in 0.2 mg/ml concentration. The meanfollow-up period was 28 months (24-36). All of the caseswere advanced glaucoma patients and 21mmHg IOP levelcould not be achieved in spite of maximum treatmentwith three drugs.Results: Of the 35 patients that were included to study,19 were male and 16 were female and the mean age was52.5±1.8 years (range, 45-73). Twenty-seven of eyeswere primary open angle glaucoma, 11 was pseudoexfoliativeglaucoma, 3 were angle closure glaucoma. In 5eyes (12.1%) there were early hypotonia. Additional suturationwas made in 2 eyes with hypotonia. Two eyes weretreated with tight patching. Suture addition was made in1 eye with choroid effusion. Cataract was developed in4 eyes. There were 3 cystic bleb (7.3%) and they weretreated with needle application. Thin avascular bleb wasdeveloped in 10 eyes (24.4%). In other eyes (68.3%)there were thin diffuse bleb formations. When targetedIOP was considered as 15 mmHg, targeted IOP wasachieved in 36 (87.8%) eyes.Conclusion: We suggest that trabeculectomy with largearea MMC application is an effective choice in advancedglaucoma patients in which targeted IOP can not beachieved with maximum medical treatment.Key words: Mitomycin-C, trabeculectomy, bleb