Episcleral versus combined episcleral and intrascleral application of mitomycin-C in trabeculectomy.

BACKGROUND AND OBJECTIVE: To determine whether intrascleral exposure to mitomycin-C (MMC) improves the control of intraocular pressure (IOP), increases the incidence of complications, or both. PATIENTS AND METHODS: The authors retrospectively evaluated 38 eyes of 29 patients following the intraoperative application of MMC (0.2 mg/ml; 5 minutes). In 21 eyes the MMC-soaked sponge was applied to the intact episclera (episcleral group). In 17 eyes, two sponges, one episcleral and the other intrascleral (sandwich group), were applied. The median follow-up times were 19.0 (episcleral group) and 24.0 (sandwich group) months. Outcome measures were the IOP the number of medications, success rates, and the incidence of complications, RESULTS: The only statistically significant difference between the two groups was the 2-week postoperative IOP! which was significantly lower in the episcleral group (P=.0314). CONCLUSION: Because there is no additional benefit, the authors recommend that the intrascleral application of MMC be avoided. However, they did not observe increased complication rates when MMC was applied in this way.