Adjunctive subconjunctival mitomycin C in glaucoma triple procedure

• Published in: Ophthalmology (Rochester, Minn.) Vol. 102; no. 10; p. 1550
• Main Authors: Shin, D H, Simone, P A, Song, M S, Reed, S Y, Juzych, M S, Kim, C, Hughes, B A
• Format: Journal Article
• Language: English
• Published: United States 01-10-1995
• Subjects: Aged; Antibiotics, Antineoplastic - administration & dosage; Cataract - complications; Chemotherapy, Adjuvant; Conjunctiva; Female; Follow-Up Studies; Glaucoma, Open-Angle - complications; Glaucoma, Open-Angle - drug therapy; Glaucoma, Open-Angle - surgery; Humans; Intraocular Pressure; Lenses, Intraocular; Male; Mitomycin - administration & dosage; Phacoemulsification; Prospective Studies; Trabeculectomy; Visual Acuity
• ISSN: 0161-6420
• DOI: 10.1016/S0161-6420(95)30832-9

To evaluate the potential benefit of adjunctive subconjunctival mitomycin in patients with primary open-angle glaucoma undergoing primary trabeculectomy combined with phacoemulsification and intraocular lens implantation.
Seventy-eight eyes of 78 patients with primary open-angle glaucoma with visually symptomatic cataracts and no previous incisional surgery were randomized to receive either no mitomycin C or a subconjunctival application of 1-, 3-, or 5-minute mitomycin C (0.5 mg/ml).
Follow-up (mean +/- standard deviation) was 21.0 +/- 7.7 months. The mean postoperative intraocular pressures were significantly lower with significantly less medications than the preoperative values at each follow-up time (1, 3, 6, 9, 12, 15 months, and last follow-up) for all groups (P < 0.05 for each). However, there was no significant difference at each follow-up time in intraocular pressure, medications, or best-corrected visual acuity among the four groups or between the control and the total mitomycin C group.
Adjunctive subconjunctival mitomycin C did not further improve the final intraocular pressure outcome of the primary trabeculectomy combined with phacoemulsification and intraocular lens implantation in patients with primary open-angle glaucoma. Future studies will determine the appropriate role, if any, for adjunctive mitomycin C in selected primary glaucoma triple procedures.