Trabeculectomy With Mitomycin

TLDR

The study compares mitomycin with fluorouracil as adjuncts to trabeculectomy in glaucoma eyes with poor surgical prognosis. Thirty‑two eyes were randomized to receive either a single 0.2 mg dose of mitomycin during surgery or ten 5 mg subconjunctival injections of fluorouracil over two weeks, with follow‑up of 7–12 months. Mitomycin achieved a higher success rate (88 % vs 47 %) and fewer corneal complications (12 % vs 53 %) than fluorouracil, while other complications were comparable.

Abstract

We conducted a prospective, randomized study to compare mitomycin with fluorouracil for efficacy and safety as an adjunct to trabeculectomy in eyes with glaucoma with poor surgical prognosis. Thirty-two eyes of 32 patients were randomly allocated to either mitomycin (17 eyes) or fluorouracil therapy (15 eyes). Mitomycin (0.2 mg) was applied only once during trabeculectomy, and fluorouracil (5 mg) was subconjunctivally injected 10 times in the 2 weeks after surgery. Fifteen eyes (88%) in the mitomycin group and seven (47%) in the fluorouracil group achieved an intraocular pressure of less than or equal to 20 mm Hg without antiglaucoma medication. The follow-up period was 7 to 12 months. Corneal complications were less common in the group given mitomycin than in that given fluorouracil (12% vs 53%). The incidence of other complications was similar between the two groups.