Purpose:
To investigate the efficacy and safety of trabeculectomy with mitomycine C (MMC) in ases with aphakic and pseudophakic open angle glaucoma.
Methods:
We retrospectively evaluated the results of trabeculectomy with MMC performed on 14 pseudophakic and 9 aphakic open angle glaucoma patients. Intraoperative MMC was applied in a concentration of 0.2 mg/ml for 3 minutes. Postoperative mean follow-up time was 29.4±16.8 months. Preoperative and postoperative data were compared statistically. Statistical significance was accepted as p<0.05.
Results:
Mean age of the cases was 52.1±16 years. Sixteen cases were male and 7 cases were female. Anterior chamber lens was present in 4 and posterior chamber lens in 10 pseudophakic patients. Mean preoperative basal intraocular pressure (IOP) was 34.9±1.6 mmHg, whereas it was measured as 17.4±0.7 mmHg in the last control. The postoperative antiglaucomatous medication number decreased to 1.2±0.2 from the preoperative mean value of 2.7±0.2. The decrease at IOPs and in the number of antiglaucomatous medication were statistically significant (p<0.001). Early postoperative hypotony was observed in 2 cases and they disappeared without any intervention. We performed retrabeculectomy with MMC in 2 cases (in 1st and 2nd years), endolaser cyclophotocoagualation in 1 case and cyclocryotherapy in one case in pseudophakic group to control the IOP. On the other hand we needed endolaser cyclophotocoagualation in 1 case and cyclocryotherapy in another case in aphakic group.
Conclusion:
Trabeculectomy with MMC is an effective and safe surgical technique in cases with aphakic and pseudophakic open angle glaucoma patients But it is technically difficult because of the previous surgical procedures and the presence of an intraocular lens. So the surgeon should be very careful about the intraoperative and postoperative complications and hold in mind that there could be a need for additional medical therapy or surgical interventions.
Keywords: Aphakia, pseudophakia, trabeculectomy, mitomycin C