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MMC injected into the Tenon's layer in trabeculectomy helps lower IOP

Acta Ophthalmol. 2008;86(8):866-870.

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A novel approach that injects mitomycin C into the Tenon's layer during trabeculectomy surgery, instead of applying it directly to the under-surface of the conjunctiva, showed adequate pressure lowering, a study found.

The intra-Tenon injection was administered in 108 trabeculectomies and phaco-trabeculectomies using MMC, all performed by a single consultant surgeon using a standardized technique.

"The 12-month outcome data show it to be an effective technique that compares favorably with others in the literature," the authors said.

Preoperative mean IOP was 23.6 ± 5.8 mm Hg. At 12 months postop, the mean IOP was reduced to 12.2 ± 3.9 mm Hg. Transient complications included hyphema, bleb leak and choroidal detachment. Hypotony was present in 21.3% of cases at 12 months; in addition, 21 eyes (19.4%) had cystic blebs and five eyes (4.6%) had Tenon's cysts with an IOP higher than 20 mm Hg.