Primary trabeculectomy with mitomycin C in the treatment of medically uncontrolled inflammatory glaucoma and primary open-angle glaucoma: a comparative study

Abstract

Purpose The aim of this study was to compare the outcomes of primary trabeculectomy (PT) with mitomycin C (MMC) in uveitic glaucoma (UG) and primary open-angle glaucoma (POAG). Design This is a retrospective, case–control study. Patients and methods We compared the outcomes of PT with 0.02% MMC for 2 min in 60 adult patients with POAG and 60 adult patients with UG, who underwent surgeries between January 2010 and January 2014 at two major hospitals in Birmingham, UK, and were followed up for 5 years. Trabeculectomy in both groups was performed by fornix-based conjunctival dissection. Results The patients’ age was 53.6±5.4 years in POAG patients compared with 48.3±9.45 years in UG patients, with a statistically significant difference (P=0.046). The rates of qualified success, complete success, and failure at the first, third, and fifth year postoperatively did not differ significantly between the two groups (P=0.73, 0.71, and 0.37, respectively). The maximum postoperative intraocular pressure (IOP) reduction was observed in the first year, followed by a slow rise in IOP, and the number of antiglaucoma medications until the fifth year postoperatively. The 5-year postoperative IOP differed significantly between the two groups (18.33±2.98 vs. 19.88±3.41 mmHg in the POAG vs. UG, respectively, P=0.009). Conclusion The success rate of PT with MMC in UG was not inferior to that in POAG. One-year posttrabeculectomy with MMC, the qualified success rate mildly increased at the expense of the complete success rate while the failure rate remained largely constant, indicating a constant need for additional antiglaucoma medications.

Keywords

• antiglaucoma medications
• intraocular pressure control
• primary open-angle glaucoma
• primary trabeculectomy with mitomycin c
• uveitic glaucoma