Background: Glaucoma is a chronic, progressive optic neuropathy caused by a group of ocular conditions which lead to damage to optic nerve with loss of visual function. It is the third leading cause of blindness worldwide. The common risk factor known is a raised intraocular pressure. It’s prevalence in India is between 2.2%-5.8%.Trabeculectomy is the surgical treatment for glaucoma. The surgery forms a filtering channel to the subconjunctival space and its efficacy depends upon two routes of drainage of the aqueous-through the canal of schlemm and by trans scleral route to the subconjunctival space. Mitomycin C is a anti fibroblastic agent used intraoperatively. It slows down the healing process resulting in bleb that exhibit greater filtration. It thus increases the outcome of trabeculectomy procedure. It is administered intraoperatively as a topical application as 0.01%-0.05% for 1-5 minutes.
Objective: To study the efficacy of trabeculectomy and trabeculectomy with Mitomycin C in Primary open angle glaucoma and Primary narrow angle glaucoma.
Materials and Methods: This prospective interventional clinical study was conducted between October 2018 to September 2020 at Rajah Muthiah medical college and hospital, Annamalai University, Annamalai Nagar, Tamil Nadu. Patients attending OPD of the Ophthalmology department diagnosed as a case of glaucoma were included in the study.15 patients underwent trabeculectomy and 15 patients underwent trabeculectomy with Mitomycin C. They were examined at discharge,1 week,1 month and 3 months. Visual acuity, IOP, Indirect ophthalmoscopy examination were done at every visit.
Results: Out of 30 patients around 10(33.33%) were males and 20(66.66%) were females. 40% males and 60% females underwent trabeculectomy surgery.26.7% males and 73.3% females underwent trabeculectomy with Mitomycin C. With both the surgeries, the mean IOP of both eyes showed significant drop immediately after surgery. From then there was a mild increase at 1 week,1 month and 3 months but stayed well below the preop IOP. The drop in IOP was more in the trabeculectomy with Mitomycin C group than the trabeculectomy group.
Majority of the patient had stable IOP control and did not need adjuvant medication. Only few patients developed postop complications.
Conclusion: The study concluded that trabeculectomy was successful in arresting the progression of the disease by decreasing and controlling the intraocular pressure within the normal range, along with stabilization of visual acuity. Adjuvant treatment with MMC increases the outcome of trabeculectomy.
