Fornix vs limbal-based trabeculectomy with mitomycin C.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 8703986 Publication Model: Print Cited Medium: Print ISSN: 0950-222X (Print) Linking ISSN: 0950222X NLM ISO Abbreviation: Eye (Lond) Subsets: MEDLINE

Publication: <2003->: London : Nature Publishing Group
Original Publication: [London : Ophthalmological Society of the United Kingdom, 1987-

Antibiotics, Antineoplastic/*therapeutic use ; Cornea/*surgery ; Glaucoma/*surgery ; Mitomycin/*therapeutic use ; Trabeculectomy/*methods; Adult ; Aged ; Aged, 80 and over ; Chi-Square Distribution ; Female ; Follow-Up Studies ; Glaucoma/physiopathology ; Humans ; Intraocular Pressure ; Male ; Middle Aged ; Retrospective Studies ; Surgical Flaps ; Suture Techniques ; Treatment Outcome ; Visual Acuity

Purpose: To compare the effectiveness of limbus- and fornix-based conjunctival flaps in patients undergoing trabeculectomy with mitomycin-C augmentation.
Methods: A retrospective review of the records of 71 consecutive eyes of 59 patients who underwent trabeculectomy with mitomycin C. All the patients had at least 6 months of follow-up. The first 35 eyes underwent surgery with a limbal-based flap, whereas all subsequent surgeries were by fornix-based procedures.
Results: No significant difference was detected between the groups with regard to patient demographics, preoperative visual field and intraocular pressure parameters, postoperative intraocular pressures at day 1, months 1, 3, and 6 postoperatively, need for intervention, need for supplementary glaucoma medication, and final visual acuity. There were four cases of overdrainage and hypotony in the limbal-based group, whereas none occurred in the fornix-based group. In all 83% percent of eyes in the limbal-based group achieved intraocular pressures off medication of less than 18 mmHg, whereas 94% of the fornix based group obtained such IOP control. One patient in the limbal-based group developed late postoperative endophthalmitis.
Conclusion: Trabeculectomy with MMC augmentation is a safe and effective procedure for reduction of IOP and visual rehabilitation whether a fornix- or a limbal-based conjunctival flap is utilised. In this series, there was a greater risk of excessive drainage with subsequent hypotonous complications when surgery was undertaken by a limbal-based procedure.

0 (Antibiotics, Antineoplastic)
50SG953SK6 (Mitomycin)

Date Created: 20040925 Date Completed: 20051017 Latest Revision: 20131121

20240829

10.1038/sj.eye.6701587

15389284