Purpose: Trabeculectomy with adjunctive mitomycin C is associated with high success rates in studies with follow-up of less than 1 year. This report evaluates the visual and intraocular pressure (IOP) outcome in eyes after trabeculectomy with adjunctive mitomycin C 1 to 3 years after surgery in a predominantly white group (98.1%). Methods: The records of 157 eyes of 157 consecutive patients, aged 18 or older, who underwent mitomycin C trabeculectomies for uncontrolled glaucoma of various causes were reviewed. All surgeries were performed between April 1991 and June 1993. The concentration of mitomycin C varied from 0.2 to 0.5 mg/ml and was applied for 30 seconds to 5 minutes (only one patient received 0.2 mg/ml). Of the 157 eyes, 110 eyes were at high risk for failure (previous surgeries or inflammatory glaucoma). Thirty-nine eyes had preoperative IOP ≤ 21 mmHg. Results: The mean preoperative IOP was 29.4 ± 10.3 mmHg. This was reduced to 13.0 ± 7.6 mmHg at 1 year, 11.5 ± 6.4 mmHg at 2 years, and 13.4 ± 7.3 mmHg at 3 years. Cumulative survival rate by life-table analysis was 94.2% ± 1.9% at 1 year, 92.1% ± 2.4% at 2 years, and 88.7% ± 4.0% at 3 years, where failure was defined as reoperation for control of IOP. Complications included cataract formation-progression (n = 31), hyphema (n = 26), choroidal detachment (n = 21), hypotony maculopathy (n = 5), and endophthalmitis (n = 2). Vision deteriorated in 29 eyes and improved by 2 or more Snellen visual acuity lines in 29 eyes. Conclusion: The IOP reduction after mitomycin C filtering surgery is sustained in the intermediate-term, 1 to 3 years, follow-up period.
Bibliographical noteFunding Information:
Originally received: March 15, 1996. Revision accepted: July 29, 1996. 1 Department of Ophthalmology, University of Minnesota, Minneapolis. 2 Department of Ophthalmology, Hennepin County Medical Center, Minneapolis, Minnesota. Presented in part at the ARVO Annual Meeting, Ft. Lauderdale, May 1995. Supported by an unrestricted grant from Research to Prevent Blindness, Inc., New York, New York. Reprint requests to Martha M. Wright, MD, Department of Ophthalmology, University of Minnesota, UMHC Box 493, 420 Delaware St SE, Minneapolis, MN 55455.