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Trabeculectomy surgery augmented with intra‐Tenon injection of mitomycin C
Author(s) -
Lee Edward,
Doyle Eddie,
Jenkins Christopher
Publication year - 2008
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2007.01147.x
Subject(s) - medicine , trabeculectomy , mitomycin c , ophthalmology , intraocular pressure , glaucoma , bleb (medicine) , glaucoma medication , glaucoma surgery , surgery , mortise and tenon , structural engineering , engineering
. Purpose: To describe a novel approach to mitomycin C (MC) application during trabeculectomy surgery and to report the 1‐year results of surgery using this technique. Methods: One hundred and eight consecutive trabeculectomies and phaco‐trabeculectomies using MC were performed by a single consultant surgeon, using a standardized technique. This technique involved injecting MC into the Tenon’s layer during the procedure, rather than applying it directly to the under‐surface of the conjunctiva. Results: Preoperative mean intraocular pressure (IOP) was 23.6 ± 5.8mmHg. Mean IOP 12 months following surgery was 12.2 ± 3.9 mmHg. Seventy‐six eyes (70.3%) had an IOP less than 2/3 listing IOP at 12 months without the need for anti‐glaucoma medication. Ninety‐three eyes (86%) had an IOP <21 mmHg, 79 (73%) had an IOP <16 mmHg and 62 (57%) had an IOP <14 mmHg without anti‐glaucoma medication at 12 months. Transient complications included hyphaema, bleb leak and choroidal detachment in 14.8%, 5.6% and 15.7% of cases, respectively. Hypotony (defined as IOP <7 mmHg, excluding the first day postoperatively) was seen in 21.3% of cases. At 12 months, 21 eyes (19.4%) had cystic blebs and five (4.6%) had Tenon’s cysts with an IOP greater than 20 mmHg. Conclusion: A novel means of applying intraoperative MC is described. The 12‐month outcome data show it to be an effective technique that compares favourably with others in the literature.