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Trabeculectomy with Mitomycin C Treatment Outcomes in Secondary Glaucoma at Naresuan University Hospital

Objective: To examine clinical outcomes following trabeculectomy with mitomycin C (MMC) in patients with secondary glaucoma.

Materials and Methods: The present study was a retrospective study of patients with secondary glaucoma that underwent an initial trabeculectomy with MMC at Naresuan University Hospital. The main outcome measure was postoperative intraocular pressure (IOP) at 24-month follow-up. Postoperative anti-glaucoma medication, success rate, and complications were secondary outcomes. Complete success was defined as IOP of 21 mmHg or less without any additional medication, whereas qualified success was defined as IOP of 21 mmHg or less with additional medication.

Results: The present study included 72 eyes from 68 patients. The preoperative IOP was 33.8±5.75 mmHg (mean ± standard deviation) under 3.61±0.57 anti-glaucoma medications. At 24 months, the mean postoperative IOP was 18.36±3.6 mmHg under 1.65±1.7 anti-glaucoma medications. The complete and overall success rates were 44.4% and 86.1%, respectively. Nine eyes (12.5%) developed postoperative hyphema. The eyes without hyphema were significantly better than those with hyphema (p<0.001), as determined by the Kaplan-Meier survival analysis with the log-rank test.

Conclusion: Trabeculectomy with MMC decreased IOP and the number of antiglaucoma drugs prescribed to patients with secondary glaucoma over a 24-month period. The most prevalent postoperative complication was hyphema, which was associated with postoperative failure.

Keywords: Secondary glaucoma; Trabeculectomy with MMC; Intraocular pressure (IOP); Complications