Subconjunctival injection of low-dose Mitomycin-C for treatment of failing human trabeculectomies.

Purpose: To evaluate the safety and efficacy of a low-dose Mitomycin C injected subconjunctivally after a guarded filtration operation in humans.

Methods: Fourteen patients with failing filters received an injection of 0.01 mg Mitomycin C (0.25 ml of 0.04 mg/ml solution) into the filtering bleb. Eyes with end stage glaucoma of patients with healthy or successfully operated fellow eye were selected for the treatment. In 6 of the cases 2 to 5 days later a needle revision of the bleb was performed.

Results: In 12 of the treated eyes (86%) we found a lowering of the IOP with a mean of 8.08 mmHg (range 4 to 13 mmHg) and a development of a typical wide, pale, avascular filtering bleb. Complications, such as conjunctival, scleral or corneal necrosis, wound dehiscence, bleb leaks, hypotony or any clinically detectable signs of toxic damage of the anterior segment of the eye were not observed.

Conclusion: Subconjunctival injection of low-dose Mitomycin C in the early postoperative period may offer a useful option for improving the outcome in some cases of failing trabeculectomies. This alternative method of application seems to enhance the effect of a subsequent needle revision. With the concentration used we did not find any undesirable complications after a follow-up of 1 to 9 months.