Our results of large area mitomycin C application trabeculectomy in cases with advanced glaucoma

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Objective: To evaluate large area Mitomycin-C (MMC) applied trabeculectomy results in advanced glaucoma patients in which targeted intraocular pressure (IOP) can not be achieved with maximum medical therapy. Methods: 41 eyes of 35 advanced glaucoma patients that can not be controlled with medical treatment were included to the study. Large area MMC application was applied for 2 minutes in 0.2 mg/ml concentration. The mean follow-up period was 28 months (24-36). All of the cases were advanced glaucoma patients and 21mmHg IOP level could not be achieved in spite of maximum treatment with three drugs. Results: Of the 35 patients that were included to study, 19 were male and 16 were female and the mean age was 52.5±1.8 years (range, 45-73). Twenty-seven of eyes were primary open angle glaucoma, 11 was pseudoexfoliative glaucoma, 3 were angle closure glaucoma. In 5 eyes (12.1%) there were early hypotonia. Additional suturation was made in 2 eyes with hypotonia. Two eyes were treated with tight patching. Suture addition was made in 1 eye with choroid effusion. Cataract was developed in 4 eyes. There were 3 cystic bleb (7.3%) and they were treated with needle application. Thin avascular bleb was developed in 10 eyes (24.4%). In other eyes (68.3%) there were thin diffuse bleb formations. When targeted IOP was considered as 15 mmHg, targeted IOP was achieved in 36 (87.8%) eyes. Conclusion: We suggest that trabeculectomy with large area MMC application is an effective choice in advanced glaucoma patients in which targeted IOP can not be achieved with maximum medical treatment.

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Mitomycin , C , trabeculectomy , bleb

Dicle Medical Journal

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Dicle Medical Journal