May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Trabeculectomy Revision with Mitomycin C
Author Affiliations & Notes
  • B. Woo
    Glaucoma, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York
  • S. Arthur
    Glaucoma, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York
  • R. Ritch
    Glaucoma, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York
    New York Medical College, Valhalla, New York
  • C. Tello
    Glaucoma, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York
    New York Medical College, Valhalla, New York
  • J. M. Liebmann
    Glaucoma, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, New York
    NYU School of Medicine, New York, New York
  • Footnotes
    Commercial Relationships B. Woo, None; S. Arthur, None; R. Ritch, None; C. Tello, None; J.M. Liebmann, None.
  • Footnotes
    Support Corinne Graber Research Fund of the New York Glaucoma Research Institute, New York, NY
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 839. doi:
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    • Get Citation

      B. Woo, S. Arthur, R. Ritch, C. Tello, J. M. Liebmann; Trabeculectomy Revision with Mitomycin C. Invest. Ophthalmol. Vis. Sci. 2007;48(13):839.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose:
 

To evaluate the effectiveness of revision of trabeculectomy with mitomycin-C (MMC) in eyes with failed filtration surgery.

 
Methods:
 

Consecutive patients with a single prior failed filter undergoing fornix-based revision of trabeculectomy with MMC from 9/02 to 2/06 were enrolled in this retrospective study. Success was defined as:(1) IOP <18 mmHg and reduction of IOP by 20% or medications by 2;(2) IOP <15 mmHg and reduction of IOP by 25% or medications by 2;(3) IOP <12 mmHg and reduction of IOP by 30% or medications by 2.Kaplan-Meier survival analysis was used to assess outcomes. Inflammatory glaucomas were excluded. Eyes receiving additional surgery, including bleb needling, were classified as failures.

 
Results:
 

32 eyes (30 patients; 12 men, 18 women) were enrolled. Mean patient age was 70.8 years (range, 35-95). There were 23 white, 3 black, 2 Hispanic and 2 Asian patients. Mean preoperative IOP was 23.9 mmHg ± 7.8 (SD) (range, 9-48) using a mean of 2.91 ± 1.06 medications (range, 0-5). For all eyes, mean final IOP was 17.1 mmHg ± 7.7 (range, 8-40) using a mean of 0.97 ± 1.33 medications (range, 0-4). For all successful eyes, the final mean IOP was 13.4 ± 3.8 (range, 8-18) using an average of 0.95 ± 1.43 medications (range, 0-4). At 24 months, success was 68.7%, 52.7%, and 27.3% for criteria 1, 2, and 3, respectively. Of the 10 patients who failed, 1 eye had an IOP of 19 mmHg without medications, 2 eyes underwent bleb needling, 3 eyes received tube implants, and 4 continued on medical management.

 
Conclusions:
 

Trabeculectomy revision with MMC is a viable alternative to tube-shunt implantation for many patients with a single prior failed glaucoma filtering operation.  

 
Keywords: wound healing 
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