Outcome of Mitomycin-C Augmented Trabeculectomy in Primary Congenital Glaucoma

Abstract

Purpose: To evaluate the efficacy of trabeculectomy with Mitomycin-C (MMC) in controlling intraocular pressure (IOP) in children with primary congenital glaucoma (PCG).

Material and Methods: The medical records of 37children (50 eyes) with PCG were reviewed. All patients underwent trabeculectomy with MMC (0.2 mg/ml) from January 2008 to December 2010. The pre and post-operative Intraocular pressure (IOP) was the main outcome measure evaluated using analysis of variants (ANOVA). A Successful IOP was defined as an IOP under 15 mm Hg without any antiglaucoma medication at the end of 1 year follow up.

Results: A total of 50 eyes of 37 children were evaluated. The mean ± SD age of children were 23.8 ± 14.2 months (Range 1 month to 36 months). The gender distribution showed predominance of male at 25(67.7%) and 12 (32.4%) female. The mean ± SD preoperative IOP was 30.4 ± 6.3 mm Hg (Range 22 – 52 mm Hg). The postoperative IOP at 1 month, 6 month and 12 months were 16.6 ± 8.9 mm Hg, 18.4 ± 8.5 mm Hg and 20.3 ± 8.2 mm Hg respectively (range 4 – 48 mm Hg). The mean postoperative IOP was significantly decreased compared with preoperative value (P < 0.0001). Out of 50 eyes, IOP was controlled (? 15 mm Hg) in 34 eyes (68%) at first month, while at 6 and 12 month, control was seen in 32 (64%) and 29 (58%) eyes respectively.

Conclusion: The success rate of MMC augmented trabeculectomyin terms of controlling IOP of <15 mm Hgoccurredin 58% eyes in children up to age of 3 years with PCG at the end of 1 year follow up.