DOI: 10.36347/sjams.2020.v08i12.027

Pages: 2821-2827

Background: Mitomycin-C used as adjuvant drug to enhance the outcome of trabeculectomies has no established regime regarding ideal site, dose and duration of application. The purpose of this study is to find out and compare the effect of intraoperative Mitomycin-C, in different dose schedule and time of application, emphasis being laid on intraocular pressure (IOP) lowering effect and side effects. Methods: In this prospective study, a total of 38 eyes of 28 patients were randomized into 4 groups: group A & B with 0.2mg/ml and group C & D with 0.4mg/ml mitomycin-C with one minute application repeated five times and with single five minute application respectively. All eyes undergo trabeculectomy surgery with intraoperative mitomycin-C used as per the group allocated. Surgical success was defined in terms of IOP measurements. Results: All the study groups were effective in lowering the IOP, the percentage reduction being 61.9% in group A, 54.30% in group B, 75.2% in group C, 69.9% in group D (p<0.05).The highest mean change was observed in group C as compared to group A,B&D. Postoperative bleb score was significantly higher in group D on 18 week followed by group C and A. Surgical success defined in terms of pressure control, all eyes of group C & D attained pressure reduction to 21mmHg or less without medication whereas in group A, 8 eyes (88.9%) and in group B, 6 eyes (60%) achieved complete success rate. Postoperative complications occurred more commonly in study groups in which higher concentration of Mitomycin-C was used .There was no major intraoperative complication in any of the groups. Conclusion: From the results, we suggest that the optimum dose and exposure time of Mitomycin-C in trabeculectomy may be 0.2 mg/ml, 5 applications of one minute each without increasing the complication rate.