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Gazi Üniversitesi Tıp Fakültesi Göz Hastalıkları A.D., Ankara Purpose: To compare the effects of variable Mitomycin-C (MMC) application areas during trabeculectomy on target intraocular pressure (IOP), antiglaucomatous therapy, surgical complications and bleb morphology.
Materials and Methods: Sixty six cases with primary open angle (PAAG) glaucoma who underwent trabeculectomy combined with small area (Group 1) and large area (Group 2) MMC application were evaluated retrospectively. MMC had only been applied to the scleral flap area in Group 1. whereas upper temporal and nasal quadrant in addition to the flap area in Group 2. The cases with narrow angle glaucoma, secondary glaucoma, history of previous ocular surgery and follow up period less than 2 years were exluded from the study. A full ophthalmological examination was performed in all cases and IOP measurements, morphology and the function of the blebs, necessity for anti-glaucomatous medications and complications at 1st month and 2nd year were evaluated.
Results: There were 32 cases (48.5%) in Group 1 and 34 cases (51.5%) in Group 2. The mean IOPs were 12.6±5.5 and 10.8±5.3 mmHg at 1st month (p>0.05), whereas 14.4±2.8 and 10.1±2.6 mmHg at 2nd year, respectively (p<0.05). The mean number of medications were 3.3±1.6 and 3.2±0.2 at 1st month (p>0.05), whereas 0.8±1.2 and 0.26±0.70 at 2nd year (p<0.05). There were more thin, diffuse and functional blebs in Group 2 than those of Group 1 (p>0.05), and cystic blebs were seen less than those of Group 1 (p>0.05).
Conclusion: Large area MMC application seems to increase long term success rates without increasing the complication rates in trabeculectomy. Keywords : Trabeculectomy, mitomycin C, cystic bleb, diffuse blep