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The effect of mitomycin C trabeculectomy on the progression of visual field defect in normal-tension glaucoma.

AbstractBACKGROUND:
We investigated in a prospective fashion the visual prognosis and complications in normal-tension glaucoma following unilateral trabeculectomy with adjunctive mitomycin C.
METHODS:
Trabeculectomy with adjunctive mitomycin C was carried out unilaterally in 21 cases of normal-tension glaucoma. Intraocular pressure (IOP), visual prognosis, and complications were compared between the operated eyes and the non-operated fellow eyes. The follow-up period ranged from 2 to 7 years.
RESULTS:
The IOP dropped significantly from 14.8+/-1.8 mmHg (mean +/- SD) to 9.6+/-3.9 mmHg in the operated eyes (P=0.0002, Wilcoxon signed-rank test), but did not drop in the non-operated eyes. The mean deviation (MD) was -12.69+/-6.41 dB preoperatively and -14.70+/-5.49 dB at the last clinic visit in the operated eyes, whereas in non-operated eyes it was -7.85+/-5.65 dB and -11.15+/-5.62 dB, respectively. The MD deteriorated significantly in both operated and non-operated eyes (operated eyes P=0.0239, non-operated eyes: P=0.0002; Wilcoxon signed-rank test). The MD slope was -0.37+/-0.60 dB/year and -0.71+/-0.89 dB/year for the operated and non-operated eyes, respectively (P=0.5243, Mann-Whitney U-test). Visual field deterioration was more frequently observed in the non-operated eyes by a pointwise definition of the progression (P<0.05, McNemar test). Visual acuity deteriorated in 6 of the operated eyes and in 5 of the non-operated eyes. Cataract developed in 6 (29%) of the 21 operated eyes, while among the non-operated eyes 4 (19%) developed cataract.
CONCLUSION:
Mitomycin C trabeculectomy is effective in delaying progression of visual field defect in normal-tension glaucoma, but complications may arise and cause some visual disturbance.
AuthorsY Hagiwara, T Yamamoto, Y Kitazawa
JournalGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Graefes Arch Clin Exp Ophthalmol) Vol. 238 Issue 3 Pg. 232-6 (Mar 2000) ISSN: 0721-832X [Print] Germany
PMID10796038 (Publication Type: Comparative Study, Journal Article)
Chemical References
  • Mitomycin
Topics
  • Adult
  • Aged
  • Chemotherapy, Adjuvant
  • Disease Progression
  • Female
  • Glaucoma, Open-Angle (drug therapy, physiopathology, surgery)
  • Humans
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Mitomycin (therapeutic use)
  • Postoperative Complications
  • Prognosis
  • Prospective Studies
  • Trabeculectomy
  • Vision Disorders (physiopathology)
  • Visual Acuity
  • Visual Fields

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