Trabeculectomy With Mitomycin C in Uveitic Glaucoma

Abstract

Abstract: : Purpose: To determine the effect of intraoperative application of mitomycin C on the outcome of trabeculectomy in uveiti-related glaucoma. Methods: Medical charts of 56 eyes of 46 patients with uveitic glaucoma who underwent trabeculectomy with mitomycin C from March 1995 to November 2001 were reviewed retrospectively. Inflammation was well controlled by therapy in surgery. The Kaplan–Meier survival curve of patients who could not be weaned from steroids was compared to the curve of patients free from steroid therapy at the time of trabeculectomy. We also examined the effects of simultaneous cataract surgery on surgical outcome. Success -21 was defined as intraocular pressure (IOP) less than or equal to 21 mmHg, and success -15 as IOP of 15 mmHg or lower. Results: The cumulative probability of success -21 and success -15 was 86.7 % and 48.2 %at 1 year, 71.4% and 42.8% at 2 years, 71.4 % and 42.8 %at 3 year, respectively. The results for patients on steroid therapy were almost the same as for steroid-free patients. Surgical outcome in patients without the cataract surgery was significantly better than with it at the level of success -15 (p=0.031). Conclusions:Trabeculectomy with mitomycin C is effective in controlling IOP elevation associated with uveitic glaucoma as long as the inflammation is well controlled. Simultaneous cataract surgery prevents IOP falling to a lower level.

Keywords: intraocular pressure • inflammation