The Results and Factors Influencing the Outcome of Mitomycin C Trabeculectomy in Neovascular Glaucoma

ABSTRACT

PURPOSE: To evaluate the outcome and factors that influence the outcome of trabeculectomy with adjunctive mitomycin C in eyes with medically uncontrolled neovascular glaucoma. METHODS: The records of 38 eyes who underwent mitomycin C trabeculectomies were reviewed. Success was defined as intraocular pressure of 21 mm Hg or less with or without glaucoma medications and no additional glaucoma surgery, phthisis, or loss of light perception. RESULTS: Postoperative success was obtained in 22 (57.9%) out of 38 eyes after a mean follow-up period of 18.0+/-18.9 months. The success rate was 57.9% at 1 year and 51.4% at 2 years. The main causes for failure were inadequate IOP control in 34.2% (13/38), loss of light perception in 23.5% (8/34), and progression to phthisis bulbi in 2.6% (1/38). Age of 50 years or younger was a significant risk factor for surgical failure (hazard ratio, 10.5; 95% confidence interval, 1.7 to 63.7; p=0.01). CONCLUSIONS: Trabeculectomy with mitomycin C was generally effective for the treatment of neovascular glaucoma, especially in patients over 50 years of age. However, visual loss in eyes with neovascular glaucoma was common.