Low Dose Mitomycin C Augmented Trabeculectomy in Advanced Glaucoma

Abstract

Introduction: Trabeculectomy remains the ‘gold standard’filtration surgery for reduction of intraocular pressure in Glaucoma. Mitomycin C has been found to be useful in preventing closure after filtration surgery. Literature is scarce on efficacy of lose dose Mitomycin Caugmented trabeculectomy in advanced glaucoma.

Method: Retrospective analysis of prospectively collected data from December 2013 to December 2015 was done. All patients with advanced primary Glaucoma (cupping≥ 0.9 with visual field defects and elevated intraocular pressure) who underwent primary trabeculectomy with low dose Mitomycin C (0.2 mg/ml for 2 min) with minimum follow up of one year were included in the study. Outcome was defined based on postoperative Intraocular pressure: hypotony(<6), good(7 – 15),satisfactory (16-21) and poor (>21) mm of Hg.

Result: 26 patients (19 males and 7 females)met the inclusion criteria. Both eyes were affected in four patients; therefore 30 eyes were included in final analysis. Mean age was 41.4 years. Following surgery, mean intraocular pressure decreased from 31.3 ± 13.5 mm Hg to 11.2± 4.2mm Hg at 6 monthsand 11.4 ± 4mm Hg at 1 year(paired sample T test, P value <0.001). At 1 yearfollow up, IOP was <6 in 2 patients (6.7%), 7-15 in 23 (76.7%), 16-21 in 4 (13.3%),>21 in 1 (6.3%).There was no case of wipe out phenomenon.

Conclusion: Low dose Mitomycin C (0.2 mg/ml) augmented primary trabeculectomy was found to be safe and effective for treatment of patients with advanced Glaucoma.