Surgical Outcomes of Mitomycin C Augmented Trabeculectomy in Congenital Glaucoma

Doi: 10.36351/pjo.v41i4.2113

Abstract

Purpose:  To evaluate outcomes of augmented trabeculectomy in lowering IOP in eyes with Congenital Glaucoma and to report the post-operative complications.

Study Design:  Retrospective chart review.

Place and Duration of Study:  Al-Shifa Trust Eye Hospital, Rawalpindi from July 2022 and April 2024.

Methods:  This study evaluated the outcomes of Mitomycin C-augmented trabeculectomy in 78 children (102 eyes) under 3 years of age with primary or secondary congenital glaucoma. All patients were followed for one-year post-surgery. Intraocular pressure (IOP) was measured under sedation using a hand-held Perkins applanation tonometer at various intervals up to 12 months. Surgical success was defined as achieving an IOP of ≤19 mm Hg, categorized into absolute success (without medications) and qualified success (with medications). Failure was defined as uncontrolled IOP despite topical therapy. Data were analyzed using SPSS version 23.

Results:  Of the included eyes, 59.8% had primary congenital glaucoma (PCG) and 40.2% had secondary congenital glaucoma (SCG). The mean age was 18.24 ± 9.22 months, and 41% were boys. The mean IOP at 12 months was significantly reduced compared to baseline, with no significant difference between PCG and SCG groups (p=0.76). Postoperative complications were minimal; only 11.76% required further intervention, mostly anterior chamber reformation. One case each of retinal detachment and bleb leak was successfully managed.

Conclusion:  Mitomycin C-augmented trabeculectomy is a safe and effective procedure for both PCG and SCG, with comparable success rates between the two groups at one year.