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Trabeculectomy plus MMC, alone or with phaco, reduces bleb infection rate
Ophthalmology. 2011;118(3):453-458.
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The probability of bleb-related infection was low in eyes that underwent mitomycin C-augmented trabeculectomy alone or combined with phacoemulsification, a large study found.
Data were culled from the Collaborative Bleb-related Infection Incidence and Treatment Study, which is believed to be the first prospective study to investigate filtering surgery and the incidence of bleb-related infection. The study was conducted at 34 centers in Japan.
"Herein, we have described the study and presented interim clinical outcome data, from a period of 2.5 years, on the incidence and severity of the bleb-related condition of eyes treated with mitomycin C," the study authors said. "Future articles will discuss other aspects and findings of this ongoing study."
The analysis included 908 eyes of 908 patients with glaucoma; 748 eyes underwent trabeculectomy alone and 160 eyes underwent trabeculectomy with adjunctive phacoemulsification. Mean age at the time of surgery was 63.2 years.
Kaplan-Meier survival analysis was used to determine the probability of bleb-related infection after 2.5-years of follow-up. Outcomes were recorded at 6-month intervals.
Results showed that the cumulative probability of both groups developing bleb-related infection was 1.5. The trabeculectomy cases had a 1.5 probability, and the combined surgery cases had a 1.4 probability. The between-group difference was statistically insignificant.
Cases with bleb leakage had a 5.8 probability and those with no leakage had a 1.2 probability. The difference was statistically significant (P = .037), the authors reported.