Abdul Hye.
Primary Trabeculectomy with Topical Application of Mitomycin-c in Primary Glaucoma.
Pak J Ophthalmol Jan ;16(3):124-30.

The effects of topical application of mitomycin-C in primary trabeculectomy on `postoperative control of intraocular pressure llOP) in patients of primary glaucoma were studied in thirty eyes of fifteen patients, having an average age of thrity-six years. Trabeculectomy was performed with application of 0.2mg/ml and 0.4mglml concentration of mitomycin-C before formation of lamellar scieral flap under the conjunctivo-Tenon membrane. Changes in visual acuity (VA) and peroperative and postoperative complications were also studied All patients were followed-up for upto twelve months. Average reduction in IOP was 14.04 mmHg. The overall success rate, i.e. postoperative IOP< 22mmHg without antiglaucoma therapy, was 96.66%. No significant changes in VA and visual fields were observed. There was no significant difference in success rates for postoperative control of IOP between the two concentrations of mitomycin-C (P value < 0.05). The incidence of hypotony and maculopathy was more, i.e. 12.5% with 0.4mg/ml compared with no maculopathy with 0.2mg/ml concentration, the difference being statistically insignificant (P value<0.05). The present study emphasizes the significance of use of topical mitomycin - C with primary TRAB In Pakistani patients who are relatively younger than the usual age of chronic glaucoma patients, recommending that all primary filtration procedures may be performed with 0.2mg/ml of mitomycin - C for three minutes in relatively young patients.

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