Comparison of efficacy and safety of postoperative topical low concentration Mitomycin-C versus higher concentration per operative on- flap Mitomycin-C in trabeculectomy in Pakistani population

Objective: to compare the efficacy and safety of post-operative,low concentration topical mitomycin-c (mmc) versus conventional intra-operative higher concentration mitomycin-c in trabeculectomy in pakistani population study design: quasi-experimental place and duration: layton rahmatullah benevolent trust hospital (lrbt),lahore may 15,2008 to nov 20,2009. methods: seventy eyes of 70 patients were divided randomly into groups 1 & 2 of 35 eyes each. group 1 received topical (over conjunctival surface) 3 minute application of mitomycin-c (0.1 ml of 0.05mg/ml) for three consecutive days post-operative,using a 5x5mm microsponge. group 2 received per-operative episcleral 3 minute application of mitomycin-c (0.1 ml of 0.2mg/ml) using 5x5mm microsponge. the patients were followed for 1 year to see if the intraocular pressure (iop) stays equal to or below 21 mmhg without medication. any complication that occurred during this period was made note of. results: no statistical difference in surgical success rate was found between group 1 and 2. after 1 year,group 1 had a 97%,whereas group 2 had 85.7% success rates respectively. serious complications were low among both groups. in group 1,one eye developed corneal epithelial defects. in group 2,one eye developed endophthalmitis and another hypotony related maculopathy. conclusion: topical mitomycin-c applied post-operatively for 3 consecutive days in lower concentrations is safe and at least as efficacious as intra-operative higher concentration mmc in lowering iop.