Trabeculectomy and MMC a success at nine years

In eyes with primary open angle glaucoma (POAG), trabeculectomy with low dosage mitomycin-C (MMC) and intensified postoperative management offers an increased success rate and a lower incidence of complications, according to Professor Alfredo Reibaldi of the University of Catania, Italy.

Patients with POAG, uncontrolled by therapy, who took part in a prospective, randomized, double-blind clinical trial between 1995 and 1999 were reviewed. Subjects originally underwent a trabeculectomy with MMC or saline solution and cases with >9 years follow-up were considered for review.

Of the 133 eyes included in the study, 94 had a >9 years follow-up (57 treated with MMC and 37 with placebo). An IOP of <14 mmHg was found in 47 and 17 eyes, respectively, six and 11 eyes, respectively were taking medical therapy, while four and nine eyes had undergone a re-operation. Glaucomatous visual field progression was noted in five and 16 eyes however, no significant difference was seen in incidence of cataract and other complications.

These nine-year results suggest that trabeculectomy with MMC and intensive postoperative management can significantly improve success rates and decrease the incidence of complications.