Trabeculectomy with MMC in post-traumatic angle recession glaucoma
Reviewed by Su Young

This study aimed to evaluate the outcomes of primary trabeculectomy with mitomycin-C (trab MMC) in phakic eyes with post-traumatic angle recession glaucoma with no prior intraocular surgery. Thirty-two phakic eyes of 32 patients who underwent trab MMC between January-2002 and December-2017 were included. Complete success was defined as IOP between 6- and 21mmHg without anti-glaucoma medications (AGM) and failure was with IOP >21mmHg with AGM or need for additional intervention for IOP control or loss of light perception. Subjects had a mean age (± standard deviation) of 30.6 ±12.6 years. The majority were male (97.6%), the major cause of blunt trauma was sports injury in 28/32 eyes (88%) and 24/32 eyes (75%) had >180-degree angle recession. The median (interquartile range) follow-up duration was 1.3 years (0.3,3.5). There was significant IOP reduction at one-year postoperatively (34 (28,40) to 13 (12,16) mmHg; p < 0.001). The median postoperative AGM at one-year was significantly less (4 (3,4) to 0; p < 0.001) with stable logMAR visual acuity (p = 0.24). The complete survival of trab MMC was 88% at one year and was 77% from two to five years. Complications were intraoperative vitreous prolapse needing limited vitrectomy in two eyes and postoperative choroidal detachment in two eyes that resolved with conservative management. The contralateral eyes of three patients (9.7%) developed elevated IOP during the follow-up period. The authors hypothesise this may be secondary to several factors, such as an underlying predisposition to glaucoma and missed pre-existing glaucoma. The authors conclude that trabeculectomy with mitomycin-C in phakic eyes with traumatic angle recession glaucoma had good safety and efficacy in the medium-term follow-up, however, follow up is warranted for the fellow eye.

Trabeculectomy with mitomycin-C in post-traumatic angle recession glaucoma in phakic eyes with no prior intraocular intervention.
Senthil S, Dangeti D, Battula M, et al.
SEMINARS IN OPHTHALMOLOGY
2022;37:(2):171-6.