Five-year results of trabeculectomy with mitomycin C

Background: The long-term efficacy and safety of primary trabeculectomy with mitomycin C were retrospectively studied. Methods: Sixty eyes of 60 patients with severe glaucoma, 25 female and 35 male, with a mean age of 72.5 years who underwent primary trabeculectomy with mitomycin C between 1993 and 1995 were included. Glaucoma subtypes consisted of 42 patients with primary open-angle glaucoma, 10 patients with normal-pressure glaucoma, 2 patients with chronic narrow-angle glaucoma, 5 patients with pigment dispersion syndrome and 1 patient with pseudoexfoliation syndrome. During surgery, mitomycin C 0.2 mg/ml was applied under the scleral flap for 3 min. Results: Mean intraocular pressure (IOP) decreased from 22.3+/-9.3 preoperatively to 12.6+/-3.5 mmHg postoperatively. With success defined as an IOP level of 15 mmHg or less, a success rate of 83.3% was obtained in the 1st year, dropping to 60% in the 6th year following trabeculectomy. Visual fields remained stable in 73.3% of cases during the follow-up period. LogMAR visual acuity increased from 0.2 to 0.4. Four eyes underwent cataract surgery prior to trabeculectomy. Thirteen eyes underwent cataract surgery during the follow-up period. Long-term complications were relatively mild and consisted of two cases of blebitis. Bleb reconstruction was performed in five eyes with overfiltration or bleb-related complaints. Conclusions: The present findings indicate that the additional use of mitomycin C may be justified in trabeculectomies in patients with severe glaucoma.