Outcome of Intraoperative Mitomycin C Injection in Trabeculectomy and Phacotrabeculectomy in Patients with Glaucoma
Purpose: To determine the efficacy and safety of per-operative mitomycin C injection during trabeculectomy and combined phaco-trabeculectomy in different types of glaucoma.
Study Design: Interventional case series.
Place and Duration of Study: Shifa International, between January 2018 to July 2020.
Methods: Thirty one patients requiring trabeculectomy or Phaco-trabeculectomy with mitomycin C because of maximum tolerable anti-glaucoma treatment or poor compliance were included in the study. Out of these 15 in group A underwent simple trabeculectomy with intra-operative mitomycin C and 16 patients in group B underwent phacotrabeculectomy with intra-operative mitomycin C and IOL implantation. All patients underwent an eye examination (including IOP and visual acuity) before surgery and then afterwards at 1 week, 1 month, 2 months, 6 months and 1 year. Main outcome measures were best corrected visual acuity, intra-ocular pressure and number of medications at base line and post-operatively.
Results: Demographic results of the two groups were similar. Mean follow-up period was 1 year, mean IOP was 11 in group Aand 15.5 in group B in last follow-up.Mean IOP reduction at 1 year was significant in both group A and B (p = 0.001, p = 0.022 respectively). Hypotony, post-operative inflammatory membrane and bleb fibrosis were the main complications in group A and group B.
Conclusion: Trabeculectomy with mitomycin C and phaco-trabeculectomy with mitomycin C are equally successful at lowering IOP in common types of glaucoma permitting significant and safe reduction of anti-glaucoma medications for atleast 1 year after surgery.
Key Words: Mitomycin, Glaucoma, Intra ocular pressure.