The Surgical Outcome of Primary Trabeculectomy with Mitomycin C and A Fornix-Based Conjunctival Flap Technique in Thailand†
Li-Anne Lim MD*, Panida Chindasub MD**, Naris Kitnarong MD**
Affiliation : † This article was presented in the Royal College of Ophthalmology of Thailand annual meeting in November 2006 * University of New South Wales, Australia ** Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To determine the surgical outcome of primary trabeculectomy with mitomycin C (MMC) and fornix-
based conjunctival flap technique in Thai patients.
Material and Method: This retrospective review was conducted from the clinical records of all Thai glaucoma
patients who underwent a primary trabeculectomy with MMC using a fornix-based conjunctival flap technique
by or under supervision of one ophthalmologist (NK) between February 2004 and July 2006 at Siriraj
Hospital, School of Medicine, Mahidol University, Bangkok, Thailand.
Results : There were 69 eyes from 60 patients. Postoperatively, mean intraocular pressure (IOP) was significantly
decreased from 26.1 + 11.7 mmHg to 11.7 + 4.4 mmHg (p < 0.001) and mean number of anti-glaucoma
medication was significantly reduced from 3.9 + 0.7 to 0.3 + 0.9 (p < 0.001) at last visit. Sixty-seven eyes
(96.8%) were considered as success. Eight eyes (11.6%) in this group needed topical anti-glaucoma medications.
Two eyes (2.9%) were considered as failure. Mean follow-up period was 7.7 + 4.0 months. Complications
included bleb leaking in 16 eyes, choroidal detachment in four eyes, and blebitis in two eyes. Seven eyes with
leaking bleb resolved spontaneously.
Conclusion : Primary trabeculectomy with MMC using a fornix-based conjunctival flap technique is effective
as a treatment for Thai glaucoma patients. There is a high rate of success (96.8%) with the low rate of
complication.
Keywords : Glaucoma, Trabeculectomy, Antimetabolites
