Trabeculectomy with brief exposure of mitomycin C

In this study, mitomycin-C (MMC) al a concentration of 0.2 mg/mL was applied intraoperatively for 1 minute in 11 consecutive primary trabeculectomies to increase the success of glaucoma-filtration surgery while minimizing the incidence of postoperative complications resulting from MMC use. The success criteria included a postoperative intraocular pressure (IOP) lower than 21 mmHg without treatment, a 20% or more drop from preoperative IOP levels, and a visual loss limited to one or fewer lines of Snellen acuity. The procedure was considered successful in 10 eyes (90.9%), with a mean follow-up period of 25.6 weeks. Blebs were ischemic and microcystic in all successful eyes at the time of the last follow up. Postoperative complications included subconjunctival hemorrhage, hyphema, conjunctival wound leak, and corneal epithelial defects. Complications related to low IOP, such as choroidal detachment and hypotonic maculopathy, were not seen in any of the eyes. Although the longer term of follow-up results of this regimen are not well known, this alternative intraoperative application of MMC at a concentration of 0.2 mg/mL for 1 minute seems to control postoperative IOP effectively in primary trabeculectomies with fewer hypotony-related complications.