Outcome of Fornix-Based Versus Limbus-Based Conjunctival Flaps in Trabeculectomy with Mitomycin C

ABSTRACT

PURPOSE: To compare the surgical outcome of limbus-based group with that of fornix-based group undergone trabeculectomy with mitomycin C (MMC). METHODS: 46 eyes of 42 patients with trabeculectomy with MMC who were observed for 6 months or more were included. A limbus-based conjunctival flap was used for 23 eyes of 21 patients, and a fornix-based conjunctival flap for the other 23 eyes of 21 patients. And the intraocular pressure (IOP), visual acuity and postoperative complications were checked. RESULTS: In the IOP control, there were no differences between two groups after surgery except 18 months. The IOP of the limbus-based group at 18 months was lower than that of fornix-based group (10.7 +/- 9.5 14.8 +/- 11.2 mmHg, p=0.030). In the postoperative complications, the number of persistent hypotony in limbus-based group was more than that of fornix-based group (6 1 eyes, p=0.048). There were no differences between two groups in the success rates without additional medication, but the success rates of fornix-based group with additional medication at 12 months were higher than those of limbus-based group (44.4 77.3%, p=0.033). Also the cumulative success rates of fornix-based group with medication were higher than those of limbus-based group (p=0.040). CONCLUSIONS: Fornix-based conjunctival flap which has shown lower persistent hypotony and higher success rates than that of limbus-based conjunctival flap is recommendable for trabeculectomy with MMC.