Mitomycin-C in congenital glaucoma

• Published in: Ophthalmic surgery and lasers Vol. 28; no. 12; pp. 979 - 985
• Main Authors: AGARWAL, H. C, SOOD, N. N, SIHOTA, R, SANGA, L, HONAVAR, S. G
• Format: Journal Article
• Language: English
• Published: Thorofare, NJ Slack 01.12.1997; SLACK INCORPORATED
• Subjects: Administration, Topical; Antibiotics, Antineoplastic - administration & dosage; Biological and medical sciences; Chemotherapy, Adjuvant; Child; Child, Preschool; Dose-Response Relationship, Drug; Double-Blind Method; Female; Follow-Up Studies; Glaucoma; Glaucoma - congenital; Glaucoma - therapy; Humans; Infant; Infant, Newborn; Intraocular Pressure - drug effects; Male; Medical sciences; Mitomycin - administration & dosage; Ophthalmic Solutions; Postoperative Complications - prevention & control; Prospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Trabeculectomy; Human; Postoperative; Trabeculectomy; Chemoprophylaxis; Mitomycin; Congenital; Congenital disease; Eye disease; Antimetabolic; Glaucoma (eye); Surgery; Complication; Combined treatment; Comparative study
• ISSN: 1082-3069; 2325-8160; 2325-8179

To evaluate the adjunctive use of mitomycin-C (MMC) during trabeculotomy and trabeculectomy for eyes with high-risk congenital glaucoma. A prospective, randomized, double-blind study was performed to compare the effect of a single, 4-minute intraoperative exposure to 0.2 mg/ml (group 1) or 0.4 mg/ml (group 2) of MMC on trabeculotomy with trabeculectomy in 16 high-risk cases (30 eyes) of congenital glaucoma. The preoperative and final postoperative intraocular pressures (IOPs) of the two groups did not differ significantly. At the final follow-up, IOP control (< 21 mm Hg) without medications was achieved in 60% of the eyes in group 1 and in 86.67% of the eyes in group 2 (P = 21). With medication, IOP control was achieved in 86.7% of the eyes of each group. In both groups, the rate of surgical failure was 13.3%. Avascular, thin, sharply demarcated blebs were noted in 33.3% of the eyes from group 1 and in 66.67% of those from group 2 (P = .14). Intraoperative and postoperative hyphema and postoperative hypotony were the complications encountered in both groups, whereas serous choroidal detachment and wound leakage were seen only in group 2. Intraoperative MMC applied at a concentration of 0.2 mg/ml controlled postoperative IOP as effectively as a 0.4-mg/ml concentration in high-risk cases of congenital glaucoma, but with a lower incidence of complications and thin-walled blebs.