Journal of the Korean Ophthalmological Society 1995;36(5):844-854.
Published online May 1, 1995.
Efficacy and Safety of Mitomycin C Trabeculectomy in Patients with Uncomplicated Glaucoma Compared with Refractory Glaucoma.
Ki Bang Uhm, Seung Lyul Yu
Department of Ophthalmology, College of Medicine, Hanyang University, Seoul, Korea.
비합병녹내장에서 Mitomycin C 섬유주절제술의 안전성과 효용성
엄기방(Ki Bang Uhm),유승렬(Seung Lyul Yu)
Abstract
The efficacy and safety of mitomycin C(MMC) trabeculectomy was tested in patients with uncomplicated glaucoma(low-risk group) and the result was compared with that in patients with refractory glaucoma(high-risk group). Subjects included 37 eyes of 26 consecutive patients in low-risk group and 36 eyes of 26 patients in high-risk group. The mean preoperative IOP was 32.9 +/- 9.7 mmHg and 31.9 +/- 8.7 mmHg, respectively(p=1.45). The mean number of preoperative medications was 2.8 +/- 0.8 and 2.0 +/- 0.9, respectively(p<0.05). MMC(0.25 mg/ml or 0.5 mg/ml) was applied between Tenon's capsule and the sclera during trabeculectomy for 3 minutes in low-risk group, for 5 minutes in high-risk group. Scleral-flap was closed with tight releasable sutures. Eyes followed longer than 3 months were included(mean of 14.1 +/- 8.0 months vs 11.9 +/- 6.8 months, p=0.23). The low-risk group had better postoperative results including: a lower IOP at last follow-up(13.7 +/- 3.2 vs 17.2 +/- 8.4 mmHg, p=0.02), a better success rate(94% vs 83% with or without medications, p=0.23: 83% vs 55% without medications, p=0.02), a lower postoperative need for glaucoma medications(0.2 +/- 0.4 vs 0.6 +/- 08, p=0.005). Overall complications were similar between both groups. One of 37 eyes(3%) in the low-risk group developed a hypotony(p=0.51) and one of 36 eyes(3%) in the high-risk group developed a hypotony maculopathy(p=0.49). This study suggests that MMC trabeculectomy with tight releasable scleralflap sutures is safe and effective in controlling IOP not only in refractory glaucoma but also, more successfully, in uncomplicated glaucoma.
Key Words: Hypotony maculopathy;Mitomycin C;Primary Trabeculectomy;Uncomplicated glaucoma


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