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Impressum
Low-dose Mitomycin C in trabeculectomy: results and complications
Klatt A., Yamin M., Quentin C.-D.
Georg-August-Universität Göttingen, Klinik für Augenheilkunde, Robert-Koch-Straße 40, 37075 Göttingen
Objective: To evaluate the effect and complication rate of reduced
Mitomycin C (MMC) concentration in filtering surgery.
Methods: In this prospective study, 20 eyes of 20 Patients aged
26 to 79 years (mean: 60 +/- 14.6) had a trabeculectomy with intraoperative
application of MMC in a concentration of 0.1 mg/ml. A MMC-soaked sponge
was applied for 120 seconds. 11 eyes were treated primarily with MMC-trabeculectomy,
9 eyes had re-trabeculectomies with MMC after previous unsecessful filtering
surgery and two eyes had a cataractextraction simultaneously. The follow-up
ranged from 6 to 36 months (mean: 14 +/-9.9).
Results: The mean intraocular pressure could be lowered from preoperatively
29.0 mmHg (+/- 11.0) to 13.0 mmHg (+/- 5.6).The number of glaucoma medications
was reduced from 3 (+/- 1.3) to 0.5 (+/- 0.9). Most common complications
were temporary hypotonia and chorioidal detachment (7 eyes = 35%), bleb-scarring
(2 eyes = 10%), Seidelphenomena (2 eyes = 10%) and intraocular inflammation
(1 eye = 5%). No endophthalmitis occurred.
Conclusion: A reduced MMC concentration of 0.1 mg/ml seems to be
an effective method to prevent bleb-scarring in filtering surgery in glaucoma.
Complications are less than with higher concentrations of 0.2 to 0.4 mg/ml.