ENDOTHELIAL CELL LOSS FOLLOWING TRABECULECTOMY: A COMPARISON WITH AND WITHOUT MITOMYCIN-C

Abstract

Introduction: Adjunctive anti fibrotic agents, such as 5-fluorouracil (5-FU) or mitomycin-C (MMC), are commonly used to increase the success rate of glaucoma filtering surgery. Due to the greater potency and fewer complications, MMC is currently in widespread use in trabeculectomy. MMC is an antibiotic derived from Streptomyces caespitosus with alkylating properties that exerts its most profound cellular toxicity in the late G1 and early S cellular phases. Objectives: To compare the mean corneal endothelial cell loss after trabeculectomy with and without mitomycin-C Study design: Randomized controlled trial Settings: Department of Ophthalmology, Allied Hospital, Faisalabad Study duration: 18^th January 2024 to 17^th July 2024 Materials & Methods: A total of 60 patients with primary open angle glaucoma, of age 30-70 years of either gender were included. Patients with ocular trauma, any intraocular surgery, previous history of trabeculectomy, endothelial disorders such as corneal guttae, Fuchs endothelial dystrophy, neovascular glaucoma were excluded. Group A patients were undergone trabeculectomy with adjunctive mitomycin-C while group B patients were undergone trabeculectomy alone. Post-trabeculectomy endothelial cell counts was recorded with the help of specular microscope. Results: In my study, mean endothelial cell density pre-operatively in Group A (trabeculectomy with mitomycin-C) was 2349.80 ± 93.14 while in Group B (trabeculectomy without mitomycin-C) was 2364.93 ± 109.78. Mean endothelial cell density post-operatively in Group A (trabeculectomy with mitomycin-C) was 2179.80 ± 79.85 while in Group B (trabeculectomy without mitomycin-C) was 2282.83 ± 109.51. Mean change in endothelial cell density in Group A (trabeculectomy with mitomycin-C) was 170.0 ± 9.99 while in Group B (trabeculectomy without mitomycin-C) was 82.43 ± 7.38. Conclusion: This study concluded that mean corneal endothelial cell loss after trabeculectomy with mitomycin-C is significantly higher than without mitomycin-c