Comparison of fornix- and limbus-based conjunctival flaps in mitomycin C trabeculectomy with laser suture lysis in Japanese glaucoma patients

Purpose: To analyze the results of mitomycin C (MMC) trabeculectomy and laser suture lysis using either fornix-based (1713) or limbus-based (LB) conjunctival flaps. Methods: Eighty-two Japanese glaucoma patients were treated by MMC trabeculectomy, with 38 eyes receiving an FB conjunctival flap and 44 eyes receiving an LB conjunctival flap. Postoperative intraocular pressure (IOP), the probability of success, and complications were compared between the FB and LB groups. Results: The IOP of the FB group decreased from 21.6 +/- 7.90 mmHg to 9.75 +/- 3.23 mmHg at 12 months postoperation, and the IOP of the LB group decreased from 21.3 +/- 6.77 mmHg to 9.30 +/- 3.16 mmHg. The postoperative IOPs were similar in the two groups at all postoperative time points. A life-table analysis (Kaplan-Meier method) showed that the survival rate was similar in the two groups but tended to be lower in the early postoperative period in the FB group. Complications were similar also, with the exception of increased leakage in the FB group. Conclusions: MMC trabeculectomy results were similar between FB and LB conjunctival flaps, in agreement with previous reports. However, increased care may be warranted when an FB flap is used in MMC trabeculectomy.