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

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

Introduction: In combined cataract and glaucoma surgery insufficiency of filtering bleb is higher than in pure filtering surgery. As a reason for this a higher exudation of fibrin in combined surgery is considered. In this study we examined the influence of mitomycin on the exudation of fibrin.
Patients and methods: In a prospective randomised study we carried out a closed trabeculectomy and a cataract-extraction with phako emulsifikation and implantation of a foldable intraocular lens via the same incision in 28 patients. 14 patients received a mitomycin-sponge for 45 seconds with a concentration of 0,02% in the area of the fistulating bleb. 15 patientes were operated without cytostatic application as a control group. We examined vision, tension and the status of the glaucoma and performed an examination with laser-flare meter before surgery, in the second day, one week and six months after operation respectively.
Results: There were not statistic significant differences between the basic data. In patients without mitomycin the mean value of laser-flare at the considered days was 13,8; 23,4; 24;7 and 15,1. In patients with mitomycin the mean value was 14,2; 33,7; 45,7 and 14,3. The increase of the flare in the group with mitomycin had a regulated tension without any other interventions. In 13 of 14 patients received MMC the intraocular pressure was regulated without additional antiglaucomatous medication, in comparison to 8 of 14 patients which did not receive cytostatic agents (p<0,05).
Conclusion: The intraoperative application of mitomycin results in a significant more efficient filtration, but has no significant influence on the intra-operative and postoperative exudation of fibrin.

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