Nine-year follow-up of trabeculectomy with or without low-dosage mitomycin-c in primary open-angle glaucoma

Abstract

In POAG low-dose MMC with intensified postoperative management improved the outcome of the trabeculectomy with a low incidence of complications.

A prospective randomised trial of trabeculectomy using mitomycin C vs an ologen implant in open angle glaucoma

“…3 This was accompanied by an increase in adverse effects such as cataract formation, avascular filtering blebs, thinning of the conjunctiva, subsequent blebitis, and endophthalmitis. [3][4][5][6] The current focus is on the development of less toxic agents and implants to inhibit cicatrisation without adverse effects. One approach is the development of biodegradable implants to serve as a placeholder and prevent conjunctiva-sclera adhesion.…”

“…2,3 Although the risk profile of additional use of MMC in trabeculectomy appears low, some side effects such as cataract formation, avascular filtering blebs, thinning of the conjunctiva, subsequent blebitis, and endophthalmitis have been described. [3][4][5][6] Recently, tissue-engineered biodegradable implants have been created as an alternative augmentation in trabeculectomy. Tissue engineering involves the combination of a polymer scaffold with a population of stem, progenitor, or precursor cells.…”

Trabeculectomy Using Mitomycin C versus an Atelocollagen Implant: Clinical Results of a Randomized Trial and Histopathologic Findings

“…As described above, antimetabolites such as MMC or 5-fluorouracil are used in routine clinical practice to inhibit increased wound healing and enhance surgical success rates. The use of antimetabolites in trabeculectomy can lead to some serious side effects such as thinning of the conjunctiva, late leakage of the filtering bleb with subsequent endophthalmitis, and cataract formation [8,19,20,21]. The focus of current research is the development of agents that are less toxic but as effective as the antimetabolites.…”

Three-Year Follow-Up of Trabeculectomy with 5-Fluorouracil

“…The widespread use of antifibrotic agents, such as mitomycin C (MMC) or 5-fluorouracil (5-FU) for over 30 years, is in an attempt to improve the outcome of the procedure by inhibition of fibroblast migration and proliferation [2,3] . Antimetabolites have enhanced the success rates of primary trabeculectomy, especially in patients with high-risk factors such as neovascular glaucoma, aphakia, previous failed trabeculectomies, pseudophakia, inflammatory eye disease, recent intraocular surgery involving conjunctiva, young age, chronic use of topical medication, or patients of African or Afro-Caribbean ethnic origin [4,5] . Although the use of antifibrotics provides long-term intraocular pressure (IOP) reduction in many cases, it also involves risks of vision-threatening adverse effects such as hypotony maculopathy, cystic thin avascular bleb formation, bleb infection, flat anterior chamber, and late endophthalmitis.…”