Effect of mitomycin C and fluorouracil-supplemented trabeculectomies on the anterior segment
E. B. Dreyer, N. Chaturvedi and D. Zurakowski
Glaucoma Consultation Service, Massachusetts Eye and Ear Infirmary, Boston, Mass., USA.
OBJECTIVES: To determine whether there is increased risk to the corneal
endothelium when mitomycin C is used in trabeculectomy surgery instead of
fluorouracil, and whether these agents play a role in accelerating cataract
formation. DESIGN, SETTINGS, AND PARTICIPANTS: We analyzed the corneal
endothelium and the lens preoperatively and postoperatively in 30 eyes of
21 patients who underwent either a fluorouracil- or mitomycin
C-supplemented trabeculectomy. RESULTS: No significant differences were
found between these two groups in the rate of cataract progression,
magnitude of endothelial cell loss, or appearance of endothelial cell
morphologic characteristics. Endothelial cell loss accounted for
approximately 7% to 8% of the preoperative counts in both groups. In
addition, four (27%) of 15 eyes in each group showed evidence of cataract
progression as graded by the Lens Opacities Classification System II.
CONCLUSION: Fluorouracil- and mitomycin C-supplemented trabeculectomies
cause similar changes in the lens and corneal endothelium.
