The safety and efficacy of minimal dose of mitomycin C in trabeculectomy

Aim: To evaluate the safety and efficacy of minimal concentration and exposure time of mitomycin C (MMC) (0.1 mg/mL for 2 min) as an adjunct to trabeculectomy and to evaluate the complications of minimal dose of MMC in trabeculectomy. Background: Glaucoma ranks second as the most common cause of blindness worldwide. The introduction of MMC as an adjunct to trabeculectomy was a major advancement in the ability to improve the intraocular pressure (IOP)-lowering efficacy of the procedure. Materials and Methods: In this study, 40 patients, who had primary open-angle glaucoma, were included. Both with MMC in a dose of 0.1 mg/mL for 2 min, 20 underwent trabeculectomy alone, and 20 underwent combined surgery. Postoperative IOP at each follow-up, bleb appearance, the need for postoperative medical glaucoma treatment, and improvement of vision were recorded. We evaluated the IOP, bleb appearance, and complications on day 1, 1 week, 1 month, and 3 months postoperatively. Results: A total number of 40 patients were studied. There were 25 males and 15 females with mean age 65 ± 10 years. The IOP at 3 months follow-up was 12.0 ± 1.5 mmHg, 1 day was 17 + 1.5 mmHg, 1 week was 14.6 ± 5 mmHg, and 1 month was 12.2 ± 5 mmHg. No bleb related complications or any other complications were noted in any of the patients. In all the patients, bleb appearance was grade II-III according to Moorfields classification. Visual acuity in all the 20 patients was between 6/24 and 6/9, who underwent combined procedure. Conclusion: Trabeculectomy with intraoperative MMC in a dose of 0.1 mg/mL and exposure time of 2 min tested to be a safe and effective modality in the management of glaucoma