Intraoperative Subconjunctival Injection of Mitomycin C in Trabeculectomy

ABSTRACT

A single intraoperative application of mitomycin C(MMC) has been used to improve the surgical outcome of glaucomatous eyes. But this soaking method has a few disadvantages, including difficulty in controlling amount. The purpose of this study is to evaluate the effectiveness of intraoperative subconjunctival injection of MMC to overcome this problem. In a retrospective analysis, 29 eyes of 24 consecutive patients, who were phakic primary glaucoma, who underwent primary trabeculectomy with subconjunctival injection of MMC (0.04 mg/ml, 0.05ml) were reviewed. All patients were followed for a periods of 3 months to 1 year. Preoperative mean intraocular pressure(IOP) was 33.9 +/- 9.3mmHg. The mean IOPs after 1, 3, and 6 months were 16.4 +/- 7.0, 16.1 +/- 7.5 and 16.9 +/- 5.8 mmHg, respectively. Twenty two eyes(76%) achieved an IOP of less than 21mmHg without antiglaucoma medication. Postoperative complications were transient hyphema in 3 eyes(20%), shallow anterior chamber in 2 eyes(7%), conjunctival wound leakage in 1 eye(3%), and hypotony maculopathy in 1 eye(3%). There were 4 cases (14%) of avascular cystic bleb and 8 cases (28%) of nonfunctional fibrotic bleb. We suggested that intraoperative subconjunctival injection of MMC could control concentration and amount of MMC.