THE EFFECT OF ADJUVANT MITOMYCIN C IN AHMED GLAUCOMA VALVE SURGERY FOR REFRACTORY GLAUCOMA

Abstract

 

Purpose

 

To describe the efficacy and safety of adjuvant Mitomycin C (MMC) with glaucoma drainage device surgery in refractory glaucoma.

 

Methods

 

Retrospective case control study. Consecutive cases of Ahmed valve glaucoma (AGV) surgery performed during the study period were included. Surgery with or without adjuvant MMC was surgeon practice dependent. Patients' records were reviewed for clinical and demographic factors, treatments, intraocular pressure (IOP), visual acuity and any complications.

 

Results

 

A total of 74 eyes that underwent AGV implantation in Tan Tock Seng Hospital, Singapore, from 1st January 2001 to 31st December 2009 for refractory glaucoma. We found a statistically significant difference in success rates between patients receiving MMC and those without (p=0.011), with the MMC treated group being 4.86 times more likely to have success as compared to the non-MMC group (95% C.I: 1.45 - 16.34). There was no significant difference in complication rates between treatment groups.

 

Conclusions

 

The use of adjuvant MMC in AGV implantation is effective in improving overall surgical success in patients with refractory glaucoma.

 

 

Kaplan Meier Survival Curves: comparing treatment groups with and without MMC at 5 years

 

Keywords: 427 aqueous • 633 outflow: trabecular meshwork • 568 intraocular pressure