Outcome of Trabeculectomy with Mitomycin C in Patients with Advanced Glaucoma

Richard E Stead (1) , Anthony J King (1)

1 NUH - Nottingham University Hospitals NHS Trust

Background/Aims To determine the medium term intraocular pressure control and visual outcomes for patients with advanced glaucoma undergoing trabeculectomy with mitomycin C. Methods All patients with advanced glaucoma (MD -20dB or above) undergoing trabeculectomy with mitomycin C between 2000 and 2008 under the care of a single glaucoma surgeon were included. Intraocular pressure, visual acuity and visual field outcomes were assessed from data prospectively collected into a surgical outcome database. Results One hundred and three patients were eligible for inclusion. The post-trabeculectomy group mean IOP varied between 11.3 and 13.3mmHg between 1 and 7 years. At year 5, 85.2% had an IOP < 16mmHg and 96.3% had an IOP < 21mmHg. The number completing a reliable visual field exam decreased significantly year on year, however the change in mean MD for the group as a whole and for individual patients remained stable. 28 patients experienced a significant reduction in acuity defined as 2 or more lines of Snellen, although this was not due to glaucoma surgery in the majority. The only pre-operative determinant for a significant reduction in VA was the pre-operative MD (-27.00dB (n=21) compared with -24.79dB (n=63; p=0.029). Conclusion Trabeculectomy is a successsful method of controlling intraocular pressure in the short to medium term in patients with advanced glaucoma.

Mots clés: Field of vision; Optic Nerve; Intraocular pressure

Richard E Stead, Anthony J King. Outcome of Trabeculectomy with Mitomycin C in Patients with Advanced Glaucoma. British Journal of Ophthalmology, 2010, 95 (7), pp.960. ⟨10.1136/bjo.2010.185272⟩. ⟨hal-00602293⟩