Safety and Efficacy of Mitomycin C: Augmented Trabeculectomy: Subtenon’s Injection versus Sponge Application

Abstract

Abstract Objective: The objective of the study was to study the safety and efficacy of subtenon injection of mitomycin C (MMC) versus sponge application of MMC during trabeculectomy. Materials and Methods: Thirty-seven patients having primary glaucoma warranting trabeculectomy were enrolled in the study and their forty eyes were alternately allocated into either of the two groups: subtenon injection (ST) of 0.1 mL of 0.01% of MMC or sponge application (SP) of 0.02% of MMC and were operated by a single surgeon and followed for 3 months. The outcome was analyzed primarily based on reduction in intraocular pressure (IOP) and bleb morphology. Results: Similar outcome in terms of complete success (ST – 90% and SP – 85%), qualified success (ST – 5% and SP – 5%), and failure rate (ST – 5% and SP – 10%) was seen at the end of 3 months. The absolute reduction in IOP from the baseline was −10.00 ± 3.67 mmHg (−41.2% ± 12.30) in ST versus −8.90 ± 5.56 mmHg (−35.9% ± 16.1) in the SP group at the end of 3 months. At the end of 3 months, blebs in the ST group had low-to-medium height and in the SP group had low height. Blebs in both the groups were diffuse with mild vascularity. Antiglaucoma medications required postoperatively were 0.20 ± 0.62 versus 0.40 ± 1.10 in the ST and SP group, respectively. The duration of surgery was 19.85 ± 0.75 min in the ST group versus 22.50 ± 0.51 min in the SP group. Conclusion: Subtenon injection of MMC is as efficacious and safe as the conventional sponge application technique.