One-year follow-up results of combined mitomycin C trabeculectomy and extracapsular cataract extraction

K. M. Joos, M. J. Bueche, Paul Palmberg, William J Feuer, Alana Lee Grajewski

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Abstract

Purpose: When patients with glaucoma require cataract surgery, combined procedures offer important advantages over cataract surgery alone. Because mitomycin C has improved the success rate of a trabeculectomy in patients at high risk for filtration failure, the authors investigated whether it also would increase the survival rate of functioning filters in combined procedures. Methods: Patients with both cataract and glaucoma underwent combined mitomycin C trabeculectomy, extracapsular cataract extraction, and intraocular lens implantation. Mitomycin C (0.5 mg/ml) was applied topically to the trabeculectomy site for 5 minutes before the cataract extraction. Intraocular pressure (lOP), visual acuity, and astigmatism were measured preoperatively and postoperatively. One-year results are available for 74 patients. Results: At 1 year, 54 (73%) of 74 patients had lOPs of 15 mmHg or less without glaucoma medications. Visual acuity was 20/40 or better in 44 (60%) of 74 patients. Ten (15%) patients had a shift of more than 2 diopters of astigmatism against the rule compared with preoperative values. No notable corneal epithelial toxicity was present. Postoperative symptomatic hypotony with the wound construction occurred in 3 (4%) of 74 patients, with 1 patient requiring surgical revision. Other potential complications of mitomycin C include endothelial toxicity (1 patient had decreased vision due to endothelial folds) and wound stability (1 patient had wound rupture after direct ocular trauma). Conclusion: The 1-year Survival rate of a functioning trabeculectomy using mitomycin C in combined glaucoma and cataract surgery is encouraging. The longer-term benefits and possible adverse effects of mitomycin C in combined procedures are unknown and continue to be investigated.

Original languageEnglish
Pages (from-to)76-83
Number of pages8
JournalOphthalmology
Volume102
Issue number1
StatePublished - Jan 1 1995

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Trabeculectomy
Cataract Extraction
Mitomycin
Glaucoma
Cataract
Astigmatism
Wounds and Injuries
Visual Acuity
Survival Rate
Intraocular Lens Implantation
Intraocular Pressure
Reoperation
Rupture

ASJC Scopus subject areas

  • Ophthalmology

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One-year follow-up results of combined mitomycin C trabeculectomy and extracapsular cataract extraction. / Joos, K. M.; Bueche, M. J.; Palmberg, Paul; Feuer, William J; Grajewski, Alana Lee.

In: Ophthalmology, Vol. 102, No. 1, 01.01.1995, p. 76-83.

Research output: Contribution to journalArticle

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