Protocol for mitomycin C use in glaucoma surgery

Purpose: To evaluate the results of a protocol described for mitomycin C (MMC) use in trabeculectomy or combined surgery ( phacoemulsification and trabeculectomy). Methods: A total of 143 eyes (60 trabeculectomies and 83 combined surgeries) of 124 patients were divided into four groups: group 1 (without MMC); group 2 (with 0.1 mg/ml MMC); group 3 (with 0.2 mg/ml MMC), and group 4 (with 0.4 mg/ml MMC). Two-minute MMC was used in every case in groups 2, 3 and 4. The results were analysed after 1 year of follow-up. Intraocular pressure (IOP) and complications were evaluated. Successful IOP control was defined when IOP was < 21mmHg and < 16mmHg if advanced glaucoma was present, always without additional medical treatment. Results: Mean preoperative IOP decreased from 24.60mmHg (SD 1.40mmHg) to 13.47mmHg (SD 0.37 mmHg) (p < 0.00001), 12 months postoperatively. Control in IOP was achieved in 79.02% of eyes. No significant differences were found in final mean IOP values (p > 0.196) or in postoperative complications (p > 0.120) in groups 2, 3 and 4. Conclusion: With the protocol described, a selection of concentration of MMC has been made in different clinical forms of glaucoma. No significant differences in IOP control and postoperative complications were noticed among the groups.