Mini-trabeculectomy in eye with high rik of carring: midterm follow-up

PURPOE: To report on the urgical outcome after at leat 1 year of follow-up of mini-trabeculectomy (without cleral radial inciion), which took place in eye at high rik of potoperative filtering bleb carring. METHOD: In a propective, intitutional tudy, mini-trabeculectomy wa performed on 26 eye of 26 conecutive patient aged 40 year and older who had undergone a previou intraocular urgery or had had a pot-traumatic receed anterior chamber angle. The urgical procedure, a modification of the tandard trabeculectomy, involved a 3-mm fornix-baed conjunctival flap, clerotomy at 1 mm from the limbu, and a clerocorneal tunnel without radial inciion. During urgery, 0.4 mg per ml of mitomycin C wa applied in the cleral pocket of each eye for 3 minute. Of the 26 eye, each of two eye underwent an intraocular intervention during the firt potoperative year and therefore wa evaluated only for urgical complication. Another eye underwent inferior mini-trabeculectomy, and three other eye did not complete 12 month of follow-up. Twenty eye have completed 12 month or more of follow-up and were included in the midterm calculation of intraocular preure control. REULT: Mean preoperative intraocular preure (n = 20) wa 32.2 ± 9.5 mm Hg with 3.3 ± 0.9 hypotenive medication. After 12 to 37 month (mean, 22.1 ± 6.6) of follow-up, intraocular preure wa 20 mm Hg or le in 18 of 20 eye (90%) and the mean intraocular preure wa 17.4 ± 2.9 mm Hg (range, 12 to 23) with 1.1 ± 1.2 hypotenive medication (range, 0 to 4). At that time, the filtering bleb wa low and flehy in appearance in 15 eye (75%). Potoperative complication of the 22 eye included early potoperative aqueou leakage in one eye (4.5%); cataract extraction took place in one eye and vitrectomy wa performed in another eye, 7 and 3 month potoperatively, repectively. The four eye that were excluded from the tudy had controlled intraocular preure at the lat examination. CONCLUION: Mini-trabeculectomy in eye with high rik of carring wa found efficaciou and relatively afe. The relatively mall peritomy, the tunnel approach, and the avoidance of radial inciion eem to offer important advantage over the tandard trabeculectomy.