Aktuelle Tagungsinformationen
News and Updates
Anmeldung zur Tagung
Registration
Hotelbuchung
Hotel Registration
Grußwort
Welcome address
Beteiligte Gesellschaften
Societies involved
Eröffnung des Kongresses
Opening Ceremony
Preise
Awards
Wissenschaftliches Programm
Scientific program
Posterpräsentationen
Poster Presentation
Kurse
Courses
Begleitende Veranstaltungen
Collateral Events
Rahmenprogramm
Social program
Jubiläumsparty
Jubilee Party
DOG Information
DOG Information
Allgemeine Informationen
General Information
Autorenindex
Index of Authors
Ausstellerliste
Exhibitors
Sponsoren
Sponsors
Teilnahmegebühren
Registration fees
Impressum
DOG Homepage
Mitomycin Applied Topically For Primary Trabeculectomy
1Mietz H., 1Jacobi P. C., 1Jonescu-Cuypers C., 2Welsandt G., 1Krieglstein G. K.,
1Universität zu Köln, Zentrum für Augenheilkunde (Köln)
2Universität zu Köln, Zentrum für Augenheilkunde, Abteilung für Netzhaut- und Glaskörperchirurgie (Köln)
Objective: To assess the efficacy of a new application technique of mitomycin to enhance the outcome of filtering surgery in cases of uncontrolled glaucoma in eyes without previous filtering surgery.
Methods: We performed a prospective, randomized clinical trial. Forty-two consecutive patients scheduled for glaucoma surgery in one large surgical center were included on a consecutive basis. Patients underwent routine trabeculectomy. On the day of surgery, the surgeon was not aware to which of the two groups a patient belonged, nor was the study supervisor. In group 1, mitomycin (0.05mg/ml) was applied topically to the filtering bleb on the three days after surgery (postoperative application). In group 2, no mitomycin was applied. Pre- and post- operative IOP values, visual acuity, the need for antiglaucomatous medication, previous surgical procedures and the need for further surgical interventions were monitored.
Results: Sufficient follow-up data was available from all patients in both groups (100%). Mean follow- up was 8.5 months (range, 4-14 months) and 8.7 months (range, 2-19 months), respectively for groups 1 and 2. The mean IOP decreased from 30.5±10.2mmHg to 14.8±2.8mmHg in group 1 and from 23.1±7.1mmHg to 16.3±4.1mmHg in group 2. The mean visual acuity changed from 0.42 to 0.47 (decimals) in group 1 and from 0.46 to 0.45 in group 2. The average amount of medications decreased from 2.3±1.1 to 0.1±0.4 in group 1 and from 2.3±1.0 to 0.7±1.1 in group 2. The difference in the need for topical antiglaucomatous therapy at the last follow-up was significant (p=0.02, t-test). Complications such as failures and the need for further surgical procedures occurred once in group 1 and four times in group 2 (not significant, Mann-Whitney test). Enhancement procedures such as suture lysis and revision of the filtering bleb were infrequent and not different between the two groups.
Conclusions: The need for further antiglaucomatous therapy (complete surgical success vs. qualified surgical success) seemed to be larger in the non- mitomycin treated group. It appears therefore, that the topical postoperative application of a low dose of mitomycin improves the rate of patients with a complete surgical success. This application of mitomycin does not increase the rate of complications.