Efficacy And Surgical Outcome of Trabeculectomy with Mitomycin-C In Congenital Glaucoma with Hazy Cornea

Abstract

Glaucoma is characterized by an optic neuropathy associated with raised intraocular pressure (IOP)  and visual field defect Objective: To determine the efficacy and outcome of trabeculectomy augmented with anti-metabolite mitomycin-C in children with childhood glaucoma. Methods: A total of 40 eyes of 22 diagnosed cases of congenital glaucoma were studied. All these children underwent mitomycin-C augmented trabeculectomy from July 2017 to August 2020. The primary outcome was control of postoperative intraocular pressure (IOP) at the end of one year. A target pressure of <15mmHg was set as target pressure to label a successful surgical outcome. Results: The mean age of the patients enrolled in the study was 26.8± 12.2 years (range: 8 – 32 months) with a male to female ratio of 7:4. The mean ± SD IOP before trabeculectomy surgery was (31.5± 8.6) (range: 21 – 53) mmHg. At the one-year follow-up, the mean postoperative IOP was (19.4± 7.9) (range: 9 – 48) mmHg. Target IOP < 15 mmHg was successfully achieved in 27 (67.5%), 24 (60.0%) and 22 (55.0%) eyes at postoperative 1, 6 and 12 months respectively. Repeat trabeculectomy was required in 5 (12.5%) eyes, while 5 (12.5%) eyes developed corneal perforations and 3 (7.5%) eyes developed phthisis bulbi. Conclusion: Trabeculectomy with mitomycin C can be a primary surgical intervention in congenital glaucoma. However, repeat surgery may be required and other related surgical complications can occur after this surgery in patients with uncontrolled IOP.