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Perkins Todd W. M.D.; Gangnon, Ronald M.S.; Ladd, William M.S.; Kaufman, Paul L. M.D.; Heatley, Gregg A. M.D.
Journal of Glaucoma: August 1998
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Purpose:

This study was performed to provide results 2 to 3 years after trabeculectomy with mitomycin C (MMC).

Methods:

A consecutive series of all 68 patients who underwent trabeculectomy with MMC was analyzed using Kaplan-Meier life-table statistics and compared with other published retrospective analyses.

Results:

At 2− and 3-year follow-up examinations, 59% (95% confidence interval [CI], 44–70%) and 47% (95% CI, 32–61%) of patients, respectively, avoided an intraocular pressure (IOP) of more than 21 mmHg or less than 20% below their preoperative level without glaucoma medication on two consecutive occasions more than 1 month apart after 3 months follow-up (75% [95% CI, 60–84%] and 70% [95% CI, 53–81%], respectively, with medication) and avoided additional glaucoma surgery. Loss of more than three lines of visual acuity on two occasions more than 1 month apart after 3 months follow-up occurred in 28% of patients (>2 lines in 44%) at 3 years. Nonreversible causes of loss of three lines of acuity occurred in 13% of patients. Complications requiring reoperation occurred in 16% of patients and included hypotony maculopathy (4%) and late bleb leaks (4%).

Conclusions:

At the 3-year follow-up evaluation, trabeculectomy with MMC provided an approximately 50% chance of maintaining IOPs less than 21 mmHg and a more than 20% IOP reduction without concomitant use of glaucoma medication, which increased to 70% with the addition of medication. This procedure was associated with an approximately 30% risk of substantial visual loss (approximately 15% nonreversible) and a 15% chance of reoperation for complications.

© Williams & Wilkins 1998. All Rights Reserved.