Kohlhof K., Hille K., Krüger A., Spang S., Ruprecht K. W.

Universitäts-Augenklinik, Kirrberger Str. 1, D-66424 Homburg

Introduction: In filtrating surgery scaring of the bleb can be observed. Application of antimetabolites like mitomycin (MMC) may prevent this. Further more a higher exudation of fibrin is combined with a higher risk of filtering bleb. In this study we examined the influence of MMC on the exudation of fibrin.
Patients and methods: In a prospective randomised study 31 patients were operated on glaucoma by trabeculectomy. In 16 patients we applied a MMC-sponge for 45 seconsds with a concentration of 0,02% in the area of the fistulating bleb. 15 patients were operated without cytostatic application as a control group. Visual acuity, tension and the status of the glaucom and an examination with laser-flare-meter were performed before surgery, in the second day, one week and six months after operation respectively.
Results: There were no statistic significant differences between the basic data. In patients without MMC the mean value of laser-flare at the considered days was 12,4; 22,3; 20,0 and 11,6. In patients with MMC mean value was 9,9; 25,8; 15,6 and 10,4. The increase of the flare in the group with MMC was not statistical significant in comparison to the patients not received MMC. In 12 of the 16 patients in the group with MMC tension was regulated whereas 5 of the 15 patients which did not receive cytostatic agents had a regulated tension without any other interventions (p<0,01).
Conclusion: The intraoperative application of mitomycin results in a significant more efficient filtration, but has no significant influence on the intraoperative and postoperative exudation of fibrin.

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