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PubMed2003

Trabeculectomy outcomes in a Malaysian general hospital.

A retrospective study was conducted at the Hospital Sultanah Aminah Johor Bahru to determine the outcome of trabeculectomy surgeries over a period of 4 years. One hundred and two eyes were followed up to a maximum of 63 months (mean 34.2 months). The 2-year survival rates for plain trabeculectomies, 5-Fluorouracil augmented trabeculectomies and Mitomycin-C augmented trabeculectomies were 52.9%, 27.3% and 60.5% respectively. The commonest complications noted were cataract formation (25%) and hyphaema (11%). Mitomycin-C induced complications were rarely seen. At last follow-up, 54% of eyes had intraocular pressures below 21 mmHg without medication, while 34% of eyes had intraocular pressures below 21 mmHg with medication. Vitreous at the trabeculectomy site was a statistically significant predictor of operative failure.

Adult↗
PubMedDate not supplied

[The extraction of the crystalline lens with trabeculectomy in open-angle glaucoma].

Trabeculectomy with the extraction of the crystalline in a single operating tempo, represents a progress in the solving of two affections through a single intervention. Of the total of 101 cases of open-angle glaucoma operated and analysed on 21 patients, trabeculectomy was practised in the extraction of the crystalline (21%). The ocular tension before the operation was between 21-30 mm Hg, on 15 patients, 31-40 mm Hg, on 4 patients and over 41 mm Hg on 2 patients. As to the visual acuity, it was below 1/50, due to the opacity of the crystalline and the advanced stage of the glaucoma. The technicality varied, according to the operator--either classical Cairns trabeculectomy, or Franimopoulos-protected trepano-trabeculectomy followed by the extraction of the intracapsulated crystalline. Small postoperation hemorrhages appeared in 6 of the cases observed in the anterior chamber and 4 small hemorrhages in the vitreous body were resorbed in 7-10 days. In all cases under observation, the postoperative ocular tension kept within 11 to 17 mm Hg. The extraction of the crystalline with trabeculectomy in open-angle glaucoma is easily performed and complications are not more frequent than in the simple extraction of the crystalline.

Aged↗
PubMedDate not supplied

Comparison between phaco-deep sclerectomy converted into phaco-trabeculectomy and uneventful phaco-deep sclerectomy.

PURPOSE: To evaluate and compare the results and complications of eyes that underwent a phaco-deep sclerectomy (DS) converted into phaco-trabeculectomy due to an intraoperative macroperforation with eyes undergoing uneventful phaco-DS. METHODS: The authors reviewed 106 eyes having a planned phaco-DS; 10 of them (9.4%) had to be converted into phaco-trabeculectomy because of a large perforation during the nonpenetrating procedure. Intraocular pressure (IOP), visual acuity, glaucoma medication evolution, and complications were evaluated and compared between groups. RESULTS: Eyes undergoing uneventful phaco-DS (n=96, Group 1) had a significantly higher postoperative IOP compared with those undergoing transformed phaco-trabeculectomy (n=10, Group 2) (p<0.05). One year postoperatively, 81.2% and 100% of the eyes in the Group 1 and 2, respectively, had an IOP pound 21 mmHg without treatment (p=0.206). One year postoperatively, eyes that underwent uneventful phaco-DS needed more glaucoma medications than eyes converted into phaco-trabeculectomy (p=0.014). Visual acuity improved more quickly in Group 1 (p<0.05). Hyphema and choroidal detachment rates were significantly higher in Group 2 (p=0.002 and p=0.027, respectively). CONCLUSIONS: Phaco-DS converted into phaco-trabeculectomy provides better midterm IOP control when compared with uneventful phaco-DS, but has more complications and worse visual acuity in the early postoperative period.

Aged↗
PubMed2006

Mitomycin C "straight scleral tunnel incision"--trabeculectomy with a releasable suture.

OBJECTIVE: To evaluate the efficacy of "straight scleral tunnel incision" -trabeculectomy with a releasable suture supplemented with mitomycin C (MMC) on reducing intraocular pressure (IOP), complications, and corneal astigmatism in patients with primary angle-closure glaucoma (PACG). METHODS: Totally 217 acute or chronic PACG patients with occludable angle above 180 degrees and IOP above 21 mm Hg were divided into 3 groups. Patients in group A (98 cases, 128 eyes), B (71 cases, 95 eyes), and C (48 cases, 60 eyes) were treated with "straight scleral tunnel incision"-trabeculectomy with a releasable suture supplemented with MMC, releasable suture trabeculectomy with MMC, and trabeculectomy with MMC, respectively. IOP, complications, and surgically induced astigmatism (SIA) were evaluated preoperatively and up to 12 months postoperatively. RESULTS: IOP of 2 weeks after treatment was significantly lower than preoperative IOP in all the 3 groups (all P <0. 001). Success rates (IOP < or = 20 mm Hg) in group A, B, and C were 87.91%, 89.23%, and 83.72% respectively at 12 months after treatment (P = 0.256). The incidence of shallow anterior chamber and hypotony had no significant difference between group A and B, but both of them were lower than that in group C (P < 0.05). There were no significant differences in preoperative corneal astigmatism among the 3 groups. The corneal astigmatism after 2 weeks in group A (1.71 +/- 1.47D) was higher than that before operation (1.28 +/- 1.05D, P = 0.126). With 12 months gone, the astigmatism almost returned to preoperative levels. The corneal astigmatisms after 2 weeks in group B and C (1.99 +/- 1.20D and 2. 22 +/- 1.39D) were significantly higher than those before operation (1.20 +/- 0.85D and 1.18 +/- 0.93D, P = 0.002, P = 0.001), respectively. With 12 months gone, the mean astigmatisms in group B and C (1.87 +/- 0.91D and 1.90 +/- 1.16D) were still significantly higher than those before operation (P = 0.001, P = 0.003). The highest astigmatic polar values in group A, B, and C (1.00D, 1. 89D, and 1. 77D) occurred after 2 weeks, 1 month, and 1 month postoperation, respectively, which were significantly higher than those before operation (0.19 +/- 1.32D, 0.12 +/- 1.22D, and 0.17 +/- 1.25D, P < 0.01), respectively. With 12 months gone, they were 0. 03D, -0. 18D, and -0. 13D higher than those before operation, respectively. The rates of function bleb and thin-wall bleb were 71.43% and 26.37% in group A, 75.38% and 29.23% in group B, 72.09% and 25.58% in group C, respectively at 12 months after treatment There were no significant differences among the 3 groups. CONCLUSION: "Straight scleral tunnel incision" -trabeculectomy with a releasable suture supplemented with MMC can reduce complications and get satisfactory results in reducing IOP and SIA.

Aged↗
PubMed1995

[A case of encapsulated filtering bleb after trabeculectomy].

A case of encapsulated filtering bleb after trabeculectomy is reported. A 57-year-old man with primary open angle glaucoma underwent a trabeculectomy one year ago. Six months after the operation the filtering bleb began to shrink and intraocular pressure (IOP) began to rise. It was suspected that the trabeculectomy site was obstructed by scarring, and so sclerostomy ab interno was performed in the site with a Nd: YAG laser. The IOP was higher elevated, however, and the bleb remained unchanged with severe conjunctival injection and aqueous inflammation. The next day trabeculectomy was performed in a new site and two weeks later a dome-shaped, prominent bleb was observed with an increase in the IOP. This was diagnosed as an encapsulated filtering bleb (Tenon's capsule cyst). Cystectomy of the bleb failed and it recurred, therefore, another trabeculectomy was added and the IOP was kept at a reasonable value. We believe that it is important to pay attention to an encapsulated filtering bleb as a complication of filtering surgery after laser therapy to the anterior chamber angle.

Conjunctiva↗
PubMed1996

Predicting long-term results of trabeculectomy from early postoperative intraocular pressure levels.

BACKGROUND AND OBJECTIVES: The authors retrospectively examined the potential for early postoperative intraocular pressure to predict the long-term results of initial trabeculectomies. PATIENTS AND METHODS: The records of 173 patients (207 consecutive eyes) who underwent initial trabeculectomies, which were performed by one of the authors between 1983 and 1991, with a minimum follow-up of 150 days were reviewed. Cases of trabeculectomy combined with cataract extraction were excluded. RESULTS: The intraocular pressure during postoperative week 1 was the same for patients with successful initial trabeculectomies (success group) as it was for patients with unsuccessful trabeculectomies (failure group). However, the intraocular pressure during the second, third, and fourth weeks was significantly higher in the failure group (P < .001). Laser suture lysis and 5-fluorouracil had no influence on the fact that high intraocular pressure during the first postoperative week had no prognostic significance. CONCLUSION: Positive results on postoperative Seidel tests did not predict a poor prognosis. However, high intraocular pressure after the first week may require intervention because it predicts a poor prognosis.

Adolescent↗
PubMed1997

Trabeculectomy: complications and success in IOP control.

A retrospective study of the complications of trabeculectomy performed in the Department of Ophthalmology, Medical Faculty, Addis Ababa University between 1987-1990 is presented. Trabeculectomy was performed in 470 eyes of 354 patients during the four years period. The types of glaucomas were primary open angle glaucoma in 215 eyes (46%), primary angle closure glaucoma in 105 eyes (22%), secondary glaucoma in 117 eyes (25%) and congenital glaucoma in 33 eyes (7%). The post operative complications were shallow anterior chamber (29%), cataract (24%), hyphema (24%), uveitis (17%), choroidal detachment (4%), and conjunctival defect (3%). The post operative results show that intraocular pressure of 355 eyes (76%) were controlled with trabeculectomy alone, 17 eyes (4%) were controlled with trabeculectomy and additional medical treatment and in 98 eyes (21%), trabeculectomy with medical treatment failed to control the intraocular pressure. The overall success rate in controlling IOP was 79% and this result is similar to and comparable with results in the literature. The large exclusion (277 patients) is largely due to the fact that records could not be found.

Adolescent↗
PubMed1996

[Trabeculectomy in congenital glaucoma: retrospective medium and long-term results].

PURPOSE: We present a retrospective analysis of medium and long-term results of trabeculectomy we have performed in our department as a first surgical procedure in patients with congenital glaucoma between 1976 and 1995. MATERIAL-METHODS: Our study included 26 patients (46 eyes)(ratio M/F = 18/8) with congenital (< or = 2 months = 4 patients including 3 glaucoma present at birth), infantile (> 2 months, < or = 24 months = 18 patients) and juvenile glaucoma (> 24 months and < or = 25 years). In 42 eyes, we performed a trabeculectomy as a first surgical procedure. A trabeculectomy was combined peroperatively with a trabeculotomy in one eye and a trabeculectomy was associated with antimetabolites in 3 eyes. The trabeculodysgenesis was isolated in 38 eyes and was associated with a dysgenesis of the anterior segment in 4 eyes and a Sturge Weber syndrome in 4 other cases. The mean actual follow-up is 88.8 +/- 87.8 months (3 to 304 months) and is presently longer than 15 years in 6 patients. The mean age at the time of surgery was 24.4 months and was reduced to 4.9 months when we excluded the 4 patients with a juvenile glaucoma. An early postoperative objective refraction was performed in all patients. Correcting lenses were prescribed and associated with occlusion if needed. Beside tonometric, ophthalmoscopic and biometric monitoring, we investigated patient's final visual acuity, objective refraction, binocular vision, visual field when possible as well as their educational orientation. RESULTS: The mean 3 months (16.6 +/- 6.2 mm Hg), 12 months (16.1 +/- 6.9 mm Hg) and the mean final IOP (15.3 +/- 6.5 mm Hg) was significantly reduced compared with preoperative IOP (30.3 +/- 8.3 mm Hg). In the last exam, IOP was < or = 16 mm Hg in 33 eyes (71.7%) and < or = 20 mm Hg in 41 eyes (89.1%). Among significant postoperative complications, we observed 2 uveal effusion syndromes. The regression of the optic disc cupping was significant at every control by comparison with its preoperative evaluation. A medical adjunctive treatment was mandatory in 20 eyes. Our 5 failures concerned eyes with multiple surgical procedures. We had to perform one or more additional surgical procedures in 16 eyes (34.7%), knowing that neonatal forms and high myopic eyes have needed more additional surgical procedures. The mean period between different additional surgeries was varying in large amounts (mean period = 32 +/- 82 months). A filtration bleb was visible at the last examination in a minority of patients (n = 11 eyes). Final mean visual acuity was 0.5 +/- 0.4 (n = 35) and was > 0.8 in 10 eyes of the 14 (7 patients) with an actual follow-up longer than 120 months. CONCLUSION: In our experience, trabeculectomy may be considered as a valid and relatively safe first choice procedure in the treatment of congenital glaucoma, although requiring a frequent adjunctive medical treatment and a relatively high incidence of additional surgical procedures. The large induced IOP reduction allows to maintain an excellent visual potential in combination with orthoptic treatment in a very significant number of cases.

Female↗
PubMed1998

The effect of mitomycin-C on postoperative corneal astigmatism in trabeculectomy and a triple procedure.

BACKGROUND AND OBJECTIVE: The authors attempted to determine the effect of mitomycin-C (MMC) on postoperative corneal astigmatism in patients who underwent trabeculectomy or a triple procedure (trabeculectomy, extracapsular cataract extraction, and intraocular lens implantation). PATIENTS AND METHODS: Using the vector analysis method, the authors measured the postoperative induced astigmatism of 76 eyes in 59 patients who underwent trabeculectomy or a triple procedure with or without the application of MMC. Postoperative induced astigmatism corresponding to the 180 degrees axis was compared between the two groups. RESULTS: The patients who underwent trabeculectomy with or without MMC showed a mean induced astigmatism of -1.01 D and -2.63 D, respectively, after 1 month (P < .05), and 0.34 D and -1.42 D after 12 months (P < .05). Those who underwent a triple procedure with or without MMC showed a mean induced astigmatism of -1.81 D and -4.50 D, respectively, after 7 days (P < .05), and 1.73 D and -0.13 D, respectively, after 12 months (P < .05). The entire amount of postoperative against-the-rule astigmatic shift was similar between the with-MMC group and the without-MMC group. The against-the-rule astigmatic shift of the group without MMC reached a plateau after 3 months. However, the group with MMC showed continuous against-the-rule astigmatic shift until 12 months. CONCLUSION: This study suggests that MMC induces less with-the-rule astigmatism in early postoperative periods and continuous against-the-rule shift after 3 months following a trabeculectomy or a triple procedure.

Administration, Topical↗
PubMed1981

Trabeculectomy vs thermosclerostomy. A randomized prospective clinical trial.

In a prospective randomized clinical trial we compared the efficacy and safety of trabeculectomy and thermosclerostomy for the treatment of open angle glaucoma. Forty-eight eyes was treated by trabeculectomy and 50 eyes were treated by thermosclerostomy. The mean follow-up period was 2.7 years. Thermosclerostomy lowered intraocular pressure about 3 mm Hg lower than trabeculectomy on the average. However, the percentage of eyes with pressures less than 22 mm Hg was not different for the two operations. The main difference between trabeculectomy and thermosclerostomy was the number of complications. Postoperative flat anterior chamber, decrease in visual acuity, cataract, hypotony, and thin bleb with late perforation or infection all occurred more frequently after thermosclerostomy. In conclusion, although trabeculectomy is slightly less effective than thermosclerostomy in lowering pressure, its relative freedom from complications make it is more desirable filtering operation.

Adult↗
PubMed1975

[Cataract surgery and trabeculectomy at the same time (author's transl)].

It is not unusual to observe in the same eye a chronic glaucoma and a cataract. Surgery may be indicated for one of these diseases separately or for both of them. For simultaneous operation on glaucoma and cataract several attitudes could be discussed: a) cataract surgery and medical treatment of glaucoma, b) glaucoma surgery at first and then cataract surgery, c) cataract and glaucoma surgery at the same time. Since trabeculectomy is used for glaucoma surgery, the author performs the combined method, i.e. the simultaneous lens extraction and the operation of glaucoma through trabeculectomy. The advantages of trabec-lectomy over the other techniques for glaucoma surgery indicated that trabeculectomy over the other techniques for glaucoma surgery indicated that trabeculectomy is the best technique to be used in association with intracapsular cataract extraction. Our material consists of 65 patients, amongst which there are 11 patients with diabetes. 91 eyes have been operated upon during the last 2 years. Most of the postoperative complications, i.e. hyphaema, vitreous haemorrhage and prolapse, pupillary block, postoperatve rise of i.o. pressure are not severe and have no influence in the desired fall of i.o. pressure. It may be pointed out that a permanent regulation of i.o. pressure often occurs only 3 months postoperatively. Finally it can be said that the trabeculectomy associated with intracapsular cataract extraction appeared to be the best operation in case of glaucoma and cataract, provided that on the one hand the vascular status of these patients is controlled and on the other hand the operation microscope is exclusively used in surgery of the trabeculum.

Cataract↗
PubMed1976

Further experience with trabeculectomy.

Trabeculectomies performed on 33 eyes were compared to 28 standard filtering procedures done at the same institution during a 4 year period. The success rates in the two groups of patients whether white or black were statistically comparable, 92% in the trabeculectomy group and 77% in the standard filtering surgical group. Only cases of phakic open angle glaucoma, chronic angle closure and combined mechanism glaucoma were considered. Cases of secondary glaucoma, previous surgical failure and aphakic nonpupillary block glaucoma did uniformly poorly. When trabeculectomy was performed with "enhanced cyclodialysis" early results in a few cases were successful. The incidence of flat anterior chamber and cataracts with permanent reduction in visual acuity was significantly less in the trabeculectomy group than in the standard filtering procedure group. These results support previous studies which support trabeculectomy as successful as standard filtering procedures with the advantage of having fewer permanent serious complications.

Adult↗
PubMed1983

Blood reflux into anterior chamber after trabeculectomy.

A total of 90 eyes of 73 patients with various types of glaucoma underwent trabeculectomy and were under follow-up for a period ranging from 6 months to 8 years, with a mean of 32 months. Gonioscopy was performed using a Goldmann two-mirror contact lens; when at least one end of the internal trabeculectomy opening at the level of the trabecular tissue was free from iris adhesion the condition was designated as M1, and as M0 when the iris adhered to both ends of the opening. When the bottom of the trabeculectomy opening was visible, the condition was designated as H1, otherwise as H0. The condition of the trabeculectomy opening was then classified into three types, M1H1, M0H1 and M0H0; there were 40, 29 and 13 eyes, respectively, in each type, and in 8 eyes the condition was unclassifiable. On compression of the sclera with the base of the contact lens, a blood reflux into the anterior chamber from the vicinity of the cut ends of the Schlemm's canal was seen to occur in 22 out of 40 eyes with M1H1; this phenomenon was not observed in the other types. The incidence of the blood reflux was not correlated with the postoperative period, but intraocular pressure (IOP) control was significantly more successful in eyes with the blood reflux than those without this phenomenon. The IOP control was better in eyes with visible filtering bleb than in those without the bleb, and in eyes without the bleb, the IOP control was far superior in eyes with the blood reflux than in those without it. Tonography in selected eyes showed that the outflow facility was significantly higher in eyes with the blood reflux than in those without it. It was thought that aqueous filtration into the veins near the cut ends of the Schlemm's canal played a significant role in the IOP control after trabeculectomy.

Adult↗
PubMed1984

Focal pressure: a new method to encourage filtration after trabeculectomy.

One cause of failure of trabeculectomy is early closure of the sclerostomy with insufficient aqueous outflow and subsequent scarring of Tenon's capsule and conjunctiva. Ocular massage and other forms of manipulation of the scleral flap have been used in the past to enhance filtration in cases where full-thickness filtration procedures were performed, and they have been suggested for use with trabeculectomy as well. The authors propose a new method in which focal pressure is applied with an anesthetic-moistened applicator directly to the conjunctiva beside the edge of the scleral flap. This appears to be particularly indicated in trabeculectomy, and has both theoretical and practical advantages over the conventional forms of enhancing filtration in eyes having been treated with trabeculectomy. In 17 of 18 cases having trabeculectomy according to Watson's technique and in which it appeared that no filtration would develop in the postoperative period, focal pressure was successful in creating a satisfactory bleb.

Aqueous Humor↗
PubMed2005

The tube versus trabeculectomy study: design and baseline characteristics of study patients.

PURPOSE: The Tube Versus Trabeculectomy (TVT) Study will compare the safety and efficacy of nonvalved tube shunt surgery to trabeculectomy with mitomycin C in patients with previous intraocular surgery. DESIGN: Multicenter randomized clinical trial. METHODS SETTING: 17 Clinical Centers. STUDY POPULATION: Patients 18 to 85 years of age who have undergone previous trabeculectomy, cataract extraction with intraocular lens implantation, or both and have inadequately controlled glaucoma with intraocular pressure (IOP) >or=18 mm Hg and <or=40 mm Hg on tolerated medical therapy. INTERVENTIONS: Study patients were randomized to undergo placement of a 350-mm(2) Baerveldt glaucoma implant or trabeculectomy with mitomycin C (0.4 mg/ml for 4 minutes). MAIN OUTCOME MEASURES: IOP, complication rates, visual acuity, visual field, quality of life, reoperations for glaucoma, and need for supplemental medical therapy. RESULTS: A total of 212 patients were enrolled between October 1999 and April 2004. The age of the study population was 71.0 +/- 10.4 years (mean +/- SD), and 53% were women. The baseline IOP was 25.3 +/- 5.3 mm Hg (mean +/- SD). There were no significant differences in the demographic and ocular characteristics between the 2 treatment groups. CONCLUSIONS: Practice patterns vary in the surgical management of glaucoma, and there are differing opinions among glaucoma surgeons regarding the preferred surgical approach in patients who have undergone previous cataract extraction and/or failed filtering surgery. Forthcoming data from the TVT Study should provide valuable information comparing two surgical procedures commonly used in this patient population.

Adult↗
PubMed1992

Application of hyaluronidase after unsuccessful trabeculectomy.

Trabeculectomy fails to control the intraocular pressure (IOP) adequately in some cases. The effect of the enzyme hyaluronidase--300 IU Hylase 'Dessau' (commercially available ampuls)--applied in subconjunctival injection in the region above the filtering bleb in case of postoperative rise in IOP following trabeculectomy was studied. Successful IOP control was defined as an IOP below or equal to 20 mmHg with or without medication. The investigation concerned 62 eyes (46 patients) with primary open angle glaucoma (POAG) divided in three groups: Group I--39 eyes with early postoperative rise in IOP (7-20 days postoperatively), group II--15 eyes with late rise in IOP (6 months-1 year after surgery), group III--8 eyes with one previous unsuccessful trabeculectomy. In all examined cases IOP was over 20 mmHg (mean IOP was 26.23 +/- 3.46 mmHg) postoperatively before application of hyaluronidase. The follow up period ranged from 6 to 34 months. We found statistically significant lowering in IOP in group I (p < 0.01), group II (p < 0.05) and group III (p < 0.05). Complications related to the use of hyaluronidase were not observed up to now. Postoperative subconjunctival injection of hyaluronidase appears to improve the prognosis following unsuccessful trabeculectomy in POAG patients.

Adult↗
PubMed1991

The effect of trabeculectomy on the aqueous humor flow of the unoperated fellow eye.

Computerized anterior-chamber fluorophotometry was used to investigate the effect of unilateral antiglaucomatous trabeculectomy on the dynamics of aqueous humor in the unoperated fellow eye. In 14 patients with bilateral primary open-angle glaucoma, pigmentary glaucoma or exfoliation glaucoma, antiglaucomatous trabeculectomy was performed in one eye in which medical management of glaucoma had failed. The fellow eye in all patients had a well-defined history of glaucoma and had been treated with different sorts of medication. The medical management of the unoperated fellow eyes was continued throughout the study. Aqueous humor flow was measured in these eyes prior to surgery and on the 5th day after trabeculectomy. Systemic medication was discontinued from 48 h prior to surgery until second fluorophotometry. The average postoperative flow in the fellow eyes increased from 2.56 to 2.92 microliters/min (P less than 0.05%, paired t-test). The increase in flow in the fellow eyes was independent of topical antiglaucoma medication and of the diurnal rhythm of aqueous humor dynamics. The results of the study indicate that filtration surgery in one eye triggers a CNS-mediated, reflective increase in aqueous flow to maintain physiological stability in the anterior chamber of the surgically treated eye. Since this CNS reflex on aqueous humor dynamics affects both eyes, the clinical observation of intraocular pressure (IOP) dysregulation in the unoperated fellow eye following unilateral trabeculectomy is now understandable.

Adult↗
PubMedDate not supplied

A fluorophotometric study of corneal endothelium after trabeculectomy using different concentrations of Mitomycin-C.

The aim of the study was to determine the corneal endothelial permeability coefficient (Pac) in subjects after trabeculectomies using different concentrations of Mitomycin-C (MMC). MMC, a highly toxic drug, is not without drawbacks and complications such as corneal damage. To ascertain a possible relationship between a level of endothelial permeability (Pac) and concentrations of MMC used, we performed, in a prospective study, trabeculectomies in cases of primary open-angle glaucoma (POAG), younger than 50 years, with either concentrations of 0.5 mg/ml of MMC (group 1: 11 eyes) or 0.2 mg/ml of MMC (group 2: 10 eyes). Group 3 consisted of 8 patients after a typical trabeculectomy without MMC and served as a control group (8 eyes). In all groups, before surgery and again 1, 3 and 6 months after surgery, corneal endothelial permeability (Pac) was determined by using anterior segment fluorophotometry (Fluorotron Master). The thickness of the cornea (CT) was measured with a DGH Technology ultrasonic pachymeter. One month after surgery the mean values of Pac were statistically significantly higher in groups 1 and 2 (group 1: 4.78 x 10(-4) cm/min, group 2: 4.67 x 10(-4) cm/min) in comparison with the control group (group 3: 3.37 x 10(-4) cm/min), but the differences between groups 1 and 2 were not statistically significant (p = 0.05). Six months after operation the mean values of Pac in all groups were normalized. In eyes that underwent trabeculectomy with MMC, higher concentrations of MMC were likely to have a transient adverse effect on corneal endothelial permeability. In light of the resulting toxic intraocular effect of MMC, the damage in the function of the corneal endothelial barrier is greater with greater concentrations of MMC.

Adult↗