Adjunctive Mitomycin C in Molteno Implant Surgery

• Published in: Ophthalmology (Rochester, MN) Vol. 102; no. 1; pp. 91 - 97
• Main Authors: Perkins, Todd W., Çardakli, U. Fusun, Eisele, Jeff R., Kaufman, Paul L., Heatley, Gregg A.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.01.1995; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Eye; Female; Glaucoma - physiopathology; Glaucoma - surgery; Humans; Intraocular Pressure; Intraoperative Care; Life Tables; Male; Medical sciences; Middle Aged; Mitomycin - therapeutic use; Molteno Implants; Pharmacology. Drug treatments; Pilot Projects; Postoperative Complications; Reoperation; Treatment Outcome; Human; Chemotherapy; Eye disease; Treatment; Tube; Antimetabolic; Implant; Glaucoma (eye); Surgery; Intraoperative; Combined treatment
• ISSN: 0161-6420; 1549-4713
• DOI: 10.1016/S0161-6420(95)31048-2

Purpose: The authors assessed the efficacy of adjunctive intraoperative mitomycin C to produce lower intraocular pressures (IOPs) in patients with complicated glaucoma who underwent double-plate Molteno implantation. Methods: A pilot series of 21 consecutive patients who underwent double-plate Molteno implantation with adjunctive intraoperative mitomycin C (0.5 mg/ml) for 5 minutes was compared with a historical control group who received Molteno implants without mitomycin C (n = 18). With failure defined as an IOP greater than 21 or less than 6 mmHg at two observations 1 month apart, the addition of medication, re-operation for glaucoma, or tube removal, a life-table analysis of IOP was performed on patients with at least 3 months' follow-up. Results: Success in the mitomycin C group was higher (68% at 1 year) than the control group (17% at 1 year; P = 0.006). Loss of more than one line of vision (33%) and re-operation for complications (including flat anterior chamber, choroidal detachment, and tube blockage) (38%) were slightly but not significantly more frequent in the mitomycin C group than in the control group. Conclusion: This study suggests that intraoperative mitomycin C in conjunction with Molteno implant may offer a better chance of achieving target IOPs in the low teens in patients with complicated glaucoma than Molteno implantation alone.