Trabeculectomy with Adjunctive Mitomycin-C: Comparative Study of Subconjunctival Injection and Soaking of Mitomycin-C[II]

Lee, Sang Hyup; Choi, Young Rak; Kim, Cheol Min

Abstract

We conducted a prospective study to compare MMC subconjunctival injection with MMC soaking for surgical outcome and postoperative complications as an adjunct to trabeculectomy in eyes with glaucoma. Eleven patients with bilateral glaucoma had undergone primary trabeculectomy with adjunctive subconjunctival mitomycin-C injection in one eye[Group I] and primary trabeculectomy with subconjunctival mitomycin-C soaking in the other eye[Group II]. Minimal follow-up period was 6 months and mean follow-up period was 12.8 months. Preoperative mean IOP was 35+/-10.9 mmHg in the group Iand 33+/-14.4 mmHg in the group II, and there was no statistical significance. Postoperative mean IOP at 1, 3, 6 months were 13+/-2.3, 13+/-3.1, 13.6+/-2.9 mmHg in the group I, and 11.3+/-3.3, 12.2+/-3.4, 12.9+/-2.7 mmHg in the group IIand no statistical significance. Each of ten eyes[91%] in both groups achieved intraocular pressure of less than 21 mmHg and good bleb formation without any medication. Postoperative complications were transient hyphema[18% in the group I, 9% in the group II], cystic bleb[9% in the group I, 27% in the group II] and shallow anterior chamber[9% in the group II]. Postoperative corneal endothelial cell density per square millimeter averaged 2, 221+/-306/mm2[mean+/-standard deviation] in the group I and 2, 195+/-272/mm2in the group II and there was no statistical significance. The rates of surgical success and postoperative complications were similiar in the two groups. Subconjunctival injection has similar effect to soaking method. This method enables us to have accurate control of concentration and amount of MMC, and thereby reduces complications and improves surgical outcomes in trabeculectomy.