Trabeculectomy with adjunctive mitomycin C in pediatric glaucoma Original Reearch Article

PURPOE: To determine the afety and efficacy of trabeculectomy with adjunctive mitomycin C in patient 17 year of age or younger, and to identify rik factor for failure of thi urgical technique. METHOD: Retropective review of conecutive cae of pediatric glaucoma that underwent mitomycin C augmented trabeculectomy between January 1991 and December 1995. Forty-nine patient (60 eye) with a mean age of 7.6 year (range, 6 week to 17.6 year) were identified and followed up until repeat glaucoma urgery, or after a minimum of 6 month. ucce wa defined a intraocular preure control of 22 mm Hg or le with or without topical glaucoma control medication, no evidence of glaucoma progreion, no further glaucoma urgery neceary, and no viually devatating complication. REULT: Cumulative probabilitie of ucce ± D for 49 eye (one eye per patient) were 67% ± 13% at 12 month and 59% ± 15% at 24 month. Multivariate regreion analyi yielded the following characteritic a ignificantly increaed rik for failure: age of le than 1 year at time of urgery (rik ratio, 5.6; confidence interval, 2.1 to 14.7; P = .0005), and aphakia (rik ratio, 2.7; confidence interval, 1.1 to 6.9; P = .0364). hallow anterior chamber (17 [28%] of 60 eye) and erou choroidal detachment (13 [22%] of 60 eye) were the mot common complication. Four (11%) of 38 eye with obtainable nellen acuity were noted to have a decreae in bet-corrected viual acuity of more than 2 nellen line or lo of light perception. In 5 (8%) of 60 eye bleb-related endophthalmiti wa noted. CONCLUION: Trabeculectomy with adjunctive mitomycin C i generally effective for the treatment of pediatric glaucoma, epecially in phakic children over 1 year of age. However, late-onet bleb-related endophthalmiti i a ubtantial rik in thi patient population.