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. 2000 Jul;84(7):714–717. doi: 10.1136/bjo.84.7.714

Trabeculectomy with mitomycin C for post-keratoplasty glaucoma

M Ishioka 1, J Shimazaki 1, J Yamagami 1, H Fujishima 1, S Shimmura 1, K Tsubota 1
PMCID: PMC1723538  PMID: 10873980

Abstract

AIM—To investigate the effect of trabeculectomy with and without mitomycin C in post-keratoplasty glaucoma.
METHODS—A retrospective study was performed on patients who underwent trabeculectomy for glaucoma after penetrating keratoplasty. 34 eyes of 32 patients were included in this study. 26 eyes received trabeculectomy with mitomycin C and eight eyes without mitomycin C. The procedure was deemed successful if the intraocular pressure was maintained below 21 mm Hg with or without use of additional antiglaucoma medication (mean follow up time 22.3 (SD 10.3) months).
RESULTS—At the last examination trabeculectomy was successful in 19 of 26 eyes (73.0%) with mitomycin C (+) and two of eight (25.0%) without (p=0.0219). When the prognosis was analysed by Kaplan-Meier curve, the mitomycin C (+) group showed a better prognosis (p=0.0182). Mean intraocular pressure and average number of glaucoma medications improved in the group with mitomycin C without severe side effects on the graft. Graft rejection after trabeculectomy was seen in two eyes in the mitomycin C group. Final graft clarity rate was 69.2% (18/26) in the mitomycin C (+) group and 37.5% (3/8) in the mitomycin C (−) group. Complications such as persistent epithelial defect, cystoid macular oedema, choroidal detachment, leakage from bleb were seen in four eyes in the mitomycin C (+) group and in one eye in the mitomycin C (−) group.
CONCLUSIONS—Trabeculectomy with mitomycin C showed better results for glaucoma following keratoplasty.



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Figure 1  .

Figure 1  

Probability of surgical success in trabeculectomy of post-keratoplasty glaucoma. Surgical success is defined as the maintenance of intraocular pressure below 21 mm Hg (p=0.0182, Kaplan-Meier survival analysis with Mantel-Cox log rank test).

Figure 2  .

Figure 2  

Probability of surgical success in trabeculectomy of post-keratoplasty glaucoma with limbal transplantation. Surgical success is defined as the maintenance of intraocular pressure below 21 mm Hg (p=0.0763, Kaplan-Meier survival analysis with Mantel-Cox log rank test).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Beebe W. E., Starita R. J., Fellman R. L., Lynn J. R., Gelender H. The use of Molteno implant and anterior chamber tube shunt to encircling band for the treatment of glaucoma in keratoplasty patients. Ophthalmology. 1990 Nov;97(11):1414–1422. doi: 10.1016/s0161-6420(90)32393-x. [DOI] [PubMed] [Google Scholar]
  2. Binder P. S., Abel R., Jr, Kaufman H. E. Cyclocryotherapy for glaucoma after penetrating keratoplasty. Am J Ophthalmol. 1975 Mar;79(3):489–492. doi: 10.1016/0002-9394(75)90626-1. [DOI] [PubMed] [Google Scholar]
  3. Chien A. M., Schmidt C. M., Cohen E. J., Rajpal R. K., Sperber L. T., Rapuano C. J., Moster M., Smith M., Laibson P. R. Glaucoma in the immediate postoperative period after penetrating keratoplasty. Am J Ophthalmol. 1993 Jun 15;115(6):711–714. doi: 10.1016/s0002-9394(14)73636-0. [DOI] [PubMed] [Google Scholar]
  4. Foulks G. N. Glaucoma associated with penetrating keratoplasty. Ophthalmology. 1987 Jul;94(7):871–874. doi: 10.1016/s0161-6420(87)33542-0. [DOI] [PubMed] [Google Scholar]
  5. Kitazawa Y., Kawase K., Matsushita H., Minobe M. Trabeculectomy with mitomycin. A comparative study with fluorouracil. Arch Ophthalmol. 1991 Dec;109(12):1693–1698. doi: 10.1001/archopht.1991.01080120077030. [DOI] [PubMed] [Google Scholar]
  6. McDonnell P. J., Robin J. B., Schanzlin D. J., Minckler D., Baerveldt G., Smith R. E., Heuer D. Molteno implant for control of glaucoma in eyes after penetrating keratoplasty. Ophthalmology. 1988 Mar;95(3):364–369. doi: 10.1016/s0161-6420(88)33187-8. [DOI] [PubMed] [Google Scholar]
  7. Threlkeld A. B., Shields M. B. Noncontact transscleral Nd:YAG cyclophotocoagulation for glaucoma after penetrating keratoplasty. Am J Ophthalmol. 1995 Nov;120(5):569–576. doi: 10.1016/s0002-9394(14)72203-2. [DOI] [PubMed] [Google Scholar]
  8. Tsubota K., Satake Y., Ohyama M., Toda I., Takano Y., Ono M., Shinozaki N., Shimazaki J. Surgical reconstruction of the ocular surface in advanced ocular cicatricial pemphigoid and Stevens-Johnson syndrome. Am J Ophthalmol. 1996 Jul;122(1):38–52. doi: 10.1016/s0002-9394(14)71962-2. [DOI] [PubMed] [Google Scholar]
  9. West C. E., Wood T. O., Kaufman H. E. Cyclocryotherapy for glaucoma pre- or postpenetrating keratoplasty. Am J Ophthalmol. 1973 Oct;76(4):485–489. doi: 10.1016/0002-9394(73)90735-6. [DOI] [PubMed] [Google Scholar]
  10. WuDunn D., Alfonso E., Palmberg P. F. Combined penetrating keratoplasty and trabeculectomy with mitomycin C. Ophthalmology. 1999 Feb;106(2):396–400. doi: 10.1016/S0161-6420(99)90081-7. [DOI] [PubMed] [Google Scholar]

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