Outcome of Intraoperative Mitomycin C Injection in Trabeculectomy and Phacotrabeculectomy in Patients with Glaucoma

http://doi.org/10.36351/pjo.v37i2.1204

Abstract

Purpose:  To determine the efficacy and safety of per-operative mitomycin C injection during trabeculectomy and combined phaco-trabeculectomy in different types of glaucoma.

Study Design:  Interventional case series.

Place and Duration of Study:  Shifa International, between January 2018 to July 2020.

Methods:  Thirty one patients requiring trabeculectomy or Phaco-trabeculectomy with mitomycin C because of maximum tolerable anti-glaucoma treatment or poor compliance were included in the study. Out of these 15 in group A underwent simple trabeculectomy with intra-operative mitomycin C and 16 patients in group B underwent phacotrabeculectomy with intra-operative mitomycin C and IOL implantation. All patients underwent an eye examination (including IOP and visual acuity) before surgery and then afterwards at 1 week, 1 month, 2 months, 6 months and 1 year. Main outcome measures were best corrected visual acuity, intra-ocular pressure and number of medications at base line and post-operatively.

Results:  Demographic results of the two groups were similar. Mean follow-up period was 1 year, mean IOP was 11 in group Aand 15.5 in group B in last follow-up.Mean IOP reduction at 1 year was significant in both group A and B (p = 0.001, p = 0.022 respectively). Hypotony, post-operative inflammatory membrane and bleb fibrosis were the main complications in group A and group B.

Conclusion:  Trabeculectomy with mitomycin C and phaco-trabeculectomy with mitomycin C are equally successful at lowering IOP in common types of glaucoma permitting significant and safe reduction of anti-glaucoma medications for atleast 1 year after surgery.

Key Words:  Mitomycin, Glaucoma, Intra ocular pressure.