Surgical results and complications of mitomycin C-augmented trabeculectomy in refractory developmental glaucoma

Ophthalmic Surg Lasers. 1999 Jun;30(6):473-80.


Background and objective: To evaluate the surgical results and complications of mitomycin C-augmented trabeculectomy in refractory developmental glaucoma.

Patients and methods: The authors reviewed the charts of all patients of refractory developmental glaucoma who underwent mitomycin C-augmented trabeculectomy (0.4 mg/ml for 3 minutes) between September 1990 and August 1995. Thirty-eight eyes of 29 patients were included in the study; 34 eyes (89.5%) had refractory primary congenital glaucoma with documented failure of primary surgery, 2 eyes (5.3%) had Axenfeld-Rieger syndrome and 2 eyes (5.3%) had aniridia. The main outcome measures in this study were preoperative and postoperative intraocular pressures (IOPs),visual acuities, bleb characteristics, success rate, time of surgical failure, and complications.

Results: The IOP (mean +/- SD) reduced from a preoperative level of 32.6 +/- 11.8 mm Hg to 12.3 +/- 7.3 mm Hg (P <0.0001) with the percentage reduction in IOP being 56%. Kaplan-Meier survival analysis showed that the success probability at 18 months was 65%, which was maintained till 30 months of follow-up. The bleb was characterized by its large, elevated, avascular, transparent appearance in all the eyes. There were no intraoperative complications. The postoperative complications included hyphema (absorbed one week) in 8 eyes (21%), uncontrolled IOP in 8 eyes (21%), shallow anterior chamber in 3 eyes (7.9%), hypotony without visual loss in one eye (2.6%) and retinal detachment in 2 eyes (5.2%) which was surgically repaired successfully. Visual acuity was maintained in all cases after surgery. None of the patients developed mitomycin-C related late bleb-leakage or endophthalmitis.

Conclusion: Treatment of refractory developmental glaucoma with mitomycin C-augmented trabeculectomy is effective and safe with an acceptable rate of complications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Chemotherapy, Adjuvant
  • Child
  • Child, Preschool
  • Female
  • Glaucoma / congenital*
  • Glaucoma / drug therapy
  • Glaucoma / surgery*
  • Humans
  • Infant
  • Intraocular Pressure
  • Intraoperative Complications* / diagnostic imaging
  • Male
  • Mitomycin / therapeutic use*
  • Postoperative Complications* / diagnostic imaging
  • Safety
  • Trabeculectomy* / adverse effects
  • Treatment Outcome
  • Ultrasonography
  • Visual Acuity


  • Mitomycin