Effects of Trabeculectomy with Mitomycin-C (MMC) and without MMC in Primary Open Angle Glaucoma and Primary Angle Closure Glaucoma on 50 Cases A: Multicenter Study

Abstract

Background: Glaucoma is a leading cause of irreversible blindness worldwide. Trabeculectomy is the standard surgical procedure for controlling raised intraocular pressure (IOP) when medical treatment fails. Mitomycin-C (MMC) is used as an adjunct to improve surgical success 
by reducing postoperative fibrosis.
Objective: To evaluate the effects of trabeculectomy with MMC and without MMC in Primary Open Angle Glaucoma (POAG) and Primary Angle Closure Glaucoma (PACG) patients.
Methods: This prospective interventional study was conducted at National Institute of Ophthalmology and Hospital & Shaheed Suhrawardy Medical College and Hospital from January 2023 to December 2023. A total of 50 patients were included by purposive sampling. Among them, 30 patients underwent trabeculectomy with MMC and 20 underwent trabeculectomy without MMC. Patients were grouped as POAG and PACG cases. Preoperative and postoperative IOP, bleb morphology, surgical success, and complications were assessed during follow-up.
Results: In the MMC group (n=30), 14 (46.67%) were male and 16 (53.33%) were female, with mean age 54.7 years. In the non-MMC group (n=20), 6 (30%) were male and 14 (70%) were female, with mean age 51.05 years. In POAG patients, complete success (IOP <21 mmHg) was achieved in 100% of MMC-treated cases versus 44.44% in non-MMC cases (p<0.006). In PACG patients, complete success was achieved in 93.75% of MMC-treated cases compared with 36.36% in non-MMC cases (p<0.007).
Conclusion: Trabeculectomy with MMC was more effective than conventional trabeculectomy in maintaining bleb patency and reducing IOP in both POAG and PACG patients. MMC-augmented trabeculectomy is a safe and effective option for glaucoma surgery.

J Shaheed Suhrawardy Med Coll 2025; 17(1): 26-32