Short-and Long-Term Success Rate of Trabeculectomy Augmented by Mitomycin C in Children with Congenital Glaucoma
DOI:
https://doi.org/10.70749/ijbr.v3i4.3000Keywords:
Glaucoma, Patients, Collagen Fiber, Trabeculectomy, Effective, Managment.Abstract
Background: Primary congenital glaucoma is a rare vision-threatening disease characterized by a developmental defect of the anterior chamber angle that results in increased intraocular pressure (IOP), Habb striae, corneal edema, buphthalmos, increased corneal diameter and damage to the optic nerve. Objective: To evaluate the short- and long-term success rates of trabeculectomy augmented with mitomycin C in children with congenital glaucoma and to assess postoperative intraocular pressure (IOP) control and complications. Methods: This was a cross-sectional study conducted at the Department of Ophthalmology, Jinnah Postgraduate Medical Centre, Karachi during July 2024 to December 2024. Ninety-seven eyes of children aged 6 to 36 months with primary congenital glaucoma underwent trabeculectomy with intraoperative application of mitomycin C (0.2 mg/mL). Results: The mean age of participants was 20.4 ± 7.2 months. The mean preoperative IOP was 28.3 ± 4.7 mmHg, which reduced significantly to 14.8 ± 3.5 mmHg at 1 month and 15.2 ± 3.9 mmHg at 6 months postoperatively (p < 0.001). Surgical success was achieved in 80.4% of eyes at 1 month and in 71.1% at 6 months. Success was significantly associated with baseline IOP ≤ 30 mmHg (p = 0.04). Common complications included shallow anterior chamber (6.2%) and transient hypotony (3.1%). No cases of endophthalmitis were reported. Conclusion: It is concluded that mitomycin C–augmented trabeculectomy is effective in lowering IOP in pediatric patients with congenital glaucoma, particularly in those with moderately elevated baseline IOP. The procedure demonstrated a good safety profile with low complication rates. Further long-term studies are recommended to support these findings.
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1. Panta Sitoula, R., Gurung, J., & Anwar, A. (2021). Primary congenital glaucoma among the children under 3 years of age in the outpatient department in a tertiary care hospital: A descriptive cross-sectional study. Journal of Nepal Medical Association, 59(241), 867-870.
https://doi.org/10.31729/jnma.5889
2. Badawi, A. H., Al-Muhaylib, A. A., Al Owaifeer, A. M., Al-Essa, R. S., & Al-Shahwan, S. A. (2019). Primary congenital glaucoma: An updated review. Saudi Journal of Ophthalmology, 33(4), 382-388.
https://doi.org/10.1016/j.sjopt.2019.10.002
3. Alabdulwahhab, K. M., & Ahmad, M. S. (2020). Visual impairment and blindness in Saudi Arabia’s school for the blind: A cross-sectional Study. Clinical Optometry, 12, 169-173.
https://doi.org/10.2147/opto.s265293
4. Yu-Wai-Man, C., Arno, G., Brookes, J., Garcia-Feijoo, J., Khaw, P. T., & Moosajee, M. (2018). Primary congenital glaucoma including next-generation sequencing-based approaches: Clinical utility gene card. European Journal of Human Genetics, 26(11), 1713-1718.
https://doi.org/10.1038/s41431-018-0227-y
5. García-Antón, M. T., Salazar, J. J., De Hoz, R., Rojas, B., Ramírez, A. I., Triviño, A., Aroca-Aguilar, J., García-Feijoo, J., Escribano, J., & Ramírez, J. M. (2017). Goniodysgenesis variability and activity of CYP1B1 genotypes in primary congenital glaucoma. PLOS ONE, 12(4), e0176386.
https://doi.org/10.1371/journal.pone.0176386
6. Shen, T., Hu, W., Cai, W., Jin, H., Yu, D., Sun, J., & Yu, J. (2020). Effectiveness and safety of Trabeculectomy along with amniotic membrane transplantation on glaucoma: A systematic review. Journal of Ophthalmology, 2020, 1-9.
https://doi.org/10.1155/2020/3949735
7. Khairy, M. A., Kenawy, S., Fawzi, K. M., & Al-Nashar, H. Y. (2022). Factors affecting final surgical outcome of combined trabeculotomy–trabeculectomy in primary congenital glaucoma. Clinical Ophthalmology, 16, 43-49.
https://doi.org/10.2147/opth.s344479
8. Mahar, P. S., Memon, A. S., Bukhari, S., & Bhutto, I. A. (2012). Outcome of Mitomycin-C Augmented Trabeculectomy in Primary Congenital Glaucoma. Pakistan Journal of Ophthalmology, 28(3).
https://doi.org/10.36351/pjo.v28i3.412
9. Ali, M. H., Shah, S. R., Butt, A. N., Jamal, S., Hamza, U., & Butt, N. H. (2022). Efficacy and surgical outcome of Trabeculectomy with Mitomycin-C in congenital glaucoma with hazy cornea. Pakistan BioMedical Journal, 272-275.
https://doi.org/10.54393/pbmj.v5i5.458
10. Jabeen, S., Noorani, S., Memon, M. N., & Zaheer, N. (2022). Success rate of augmented Trabeculectomy in primary congenital glaucoma. Journal of Pediatric Ophthalmology & Strabismus, 59(3), 180-186.
https://doi.org/10.3928/01913913-20211027-01
11. Jabeen, S., Noorani, S., Memon, M. N., & Zaheer, N. (2022). Success rate of augmented Trabeculectomy in primary congenital glaucoma. Journal of Pediatric Ophthalmology & Strabismus, 59(3), 180-186.
https://doi.org/10.3928/01913913-20211027-01
12. Mandal, A. K., Kodavati, K., & Gothwal, V. K. (2022). Outcomes of management of glaucoma in Phacomatosis Pigmentovascularis over the last three decades. Ophthalmology Glaucoma, 5(1), 101-109.
https://doi.org/10.1016/j.ogla.2021.06.003
13. Mandal, A. K., Bagga, H., Nutheti, R., Gothwal, V. K., & Nanda, A. K. (2003). Trabeculectomy with or without mitomycin-C for paediatric glaucoma in aphakia and pseudophakia following congenital cataract surgery. Eye, 17(1), 53-62.
https://doi.org/10.1038/sj.eye.6700180
14. Mandal, A. K., Al-Timimi, Z., Gothwal, V. K., Kaushik, S., Senthil, S., Gupta, V., Balekudaru, S., Dubey, S., & Pillai, M. R. (2025). A survey of the congenital glaucoma surgery practice patterns in the Indian pediatric glaucoma society. Seminars in Ophthalmology, 40(5), 433-443.
https://doi.org/10.1080/08820538.2025.2457590
15. Raza, A., Chaudhary, M. A., Mushtaq, A., & Khan, A. A. (2024). Comparison between modified and conventional combined trabeculotomy-trabeculectomy with Mitomycin-C for intraocular pressure reduction in primary congenital glaucoma. Pakistan Journal of Medical Sciences, 40(9).
https://doi.org/10.12669/pjms.40.9.8788
16. Fu, X., He, J., Li, G., Luo, H., Peng, R., Cheng, Y., Peng, J., Chen, S., & Qu, C. (2024). Ahmed glaucoma valve implant for refractory glaucoma in children: A systematic review and meta-analysis.
https://doi.org/10.37766/inplasy2024.9.0088
17. Gurney, S. P., Ahmad, M., Makanjuola, T., Ramm, L., & Parulekar, M. V. (2020). Long-term efficacy of Mitomycin C augmented Trabeculectomy in a mixed pediatric glaucoma cohort. Journal of Glaucoma, 30(4), 357-361.
https://doi.org/10.1097/ijg.0000000000001759
18. Ali, M. H., Shah, S. R., Butt, A. N., Jamal, S., Hamza, U., & Butt, N. H. (2022). Efficacy and surgical outcome of Trabeculectomy with Mitomycin-C in congenital glaucoma with hazy cornea. Pakistan BioMedical Journal, 272-275.
https://doi.org/10.54393/pbmj.v5i5.458
19. Shen, R., Li, V. S., Wong, M. O., & Chan, P. P. (2023). Pediatric glaucoma—From screening, early detection to management. Children, 10(2), 181.
https://doi.org/10.3390/children10020181
20. Jesus, J., Ambrósio, J., Meira, D., Rodriguez-Uña, I., & Beirão, J. M. (2025). Blinded by the mind: Exploring the hidden psychiatric burden in glaucoma patients. Biomedicines, 13(1), 116.
https://doi.org/10.3390/biomedicines13010116
21. Knight, L. S., Ridge, B., Staffieri, S. E., Craig, J. E., Prem Senthil, M., & Souzeau, E. (2022). Quality of life in adults with childhood glaucoma. Ophthalmology Glaucoma, 5(3), 325-336.
https://doi.org/10.1016/j.ogla.2021.09.007
22. Ramesh, P. V., Morya, A. K., Azad, A., Pannerselvam, P., Devadas, A. K., Gopalakrishnan, S. T., Ramesh, S. V., & Aradhya, A. K. (2024). Navigating the intersection of psychiatry and ophthalmology: A comprehensive review of depression and anxiety management in glaucoma patients. World Journal of Psychiatry, 14(3), 362-369.
https://doi.org/10.5498/wjp.v14.i3.362
23. Knight, L. S., Ridge, B., Staffieri, S. E., Craig, J. E., Prem Senthil, M., & Souzeau, E. (2022). Quality of life in adults with childhood glaucoma. Ophthalmology Glaucoma, 5(3), 325-336.
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