Effectiveness of trabeculectomy with mitomycin C for glaucomatous eyes with low intraocular pressure on treatment eye drops

摘要

Abstract Purpose To examine the efficacy and safety of current trabeculectomy with mitomycin C in Japan for glaucomatous eyes with low intraocular pressure ( IOP ). Methods Two hundred ninety‐four eyes of 294 patients with IOP ≤21?mmHg before surgery were studied; all patients were participants in the Collaborative Bleb‐related Infection Incidence and Treatment Study ( CBIITS ), a multicentre, prospective, cohort study conducted at 34 ophthalmological institutions throughout Japan. All eyes had an intraocular pressure?≤?21?mmHg and had undergone trabeculectomy alone or phacotrabeculectomy. Two success criteria were used: Criterion A comprised 20% reduction of baseline IOP and Criterion B comprised 30% reduction of baseline IOP . The primary outcome was the success rate for each of these criteria. Results The qualified success rates were 87.3% for Criterion A and 42.0% for Criterion B at 5?years. Mean IOP was significantly reduced, from 16.7?±?2.7 to 11.6?±?4.0?mmHg at 5?years after trabeculectomy (p??0.0001); the number of anti‐glaucoma medications significantly decreased from 2.7?±?1.1 to 1.0?±?1.2 (p??0.0001) at 5 years after the surgery. Three or more trabeculectomies, and needling were related to increased risk of failure. Incidences of postoperative hyphema, infection, shallow anterior chamber and bleb leakage were 2.4%, 2.4%, 2.0% and 3.4%, respectively. Conclusions This study showed that trabeculectomy with mitomycin C is an effective procedure with few surgical complications for reducing IOP in patients, even if preoperative IOP was within the normal range.