A Comparative Study to Evaluate the Efficacy of Trabeculectomy with Pharmacologically Modulated TrabeculectomyUsing Mitomycin-C in a Tertiary Health-Care Centre

Purpose:This study was undertaken to compare the effectiveness of conventional Trabeculectomy and the Trabeculectomy with Mitomycin-C (MMC) in Glaucoma patients.Design:Prospective randomised comparative clinical study.Material and methods: Sixty patients of primary open angle glaucoma (POAG) with positive indication for filtration surgery were selected during the study period of two years. Thirty patients were subjected to routine Trabeculectomy and other group of30 patients to Trabeculectomy with MMC.Data on demographic profile, changes in the intraocular pressure (IOP), visual acuity, bleb characteristics, preoperative medications and postoperative complications were collected and analyzed in both the procedures.Results: Both the procedures are effective in reducing IOP in properly selected cases of POAG. The IOP reduction caused by both procedures is statistically significant (P<0.05). Trabeculectomy with MMC appeared to be more effective in reducing IOP (P<0.05) than the conventional trabeculectomy. Majority of the patients maintained the preoperative visual acuity after both the types of surgical procedures. It is also found that the complications produced by use of MMC are not statistically significant than those with conventional trabeculectomy.Conclusions: Trabeculectomy with and without the use of MMC is an effective surgical procedure in controlling the IOP and arresting loss of vision and visual field in patients suffering from POAG. MMC showed good results with a few complications and hence should be used only in selective high-risk patients. As MMC prevents fibrosis, its use in high-risk cases is rewarding if due precautions are taken during the surgery and postoperative follow-up.