Current Status of Mitomycin C-Augmented Trabeculectomy in Japan Based on Collaborative Bleb-Related Infection Incidence and Treatment Study

Purpose: To investigate the current status and demographics of patients who underwent mitomycin C-augmented trabeculectomy (MMC-trabeculectomy) in Japan using data from the Collaborative Bleb-related Infection Incidence and Treatment Study. Subjects and Methods: Out of 1,249 patients (1,249 eyes), we selected patients who underwent trabeculectomy alone or phacotrabeculectomy using MMC. Age at the time of surgery, type of glaucoma, pre-operative intraocular pressure (IOP) and medications, previous anti-glaucoma procedures, visual function, routine ophthalmic examination results and intra-operative complications were recorded. Results: A total of 1,098 patients (1,098 eyes) were enrolled in this study. The mean age was 63.7±13.1 years, and there were 648 males and 450 females. The mean number of anti-glaucoma eyedrops used was 2.7 types, and 40.2% of the patients concomitantly used an oral carbonic anhydrase inhibitor. The proportion of fornix-based conjunctival incision was comparable to that of limbusbased conjunctival incision. A scleral flap was created at the superior site in 99.7% of all eyes. Primary open angle glaucoma was the most predominant glaucoma subtype, followed by secondary glaucoma and psuedoexfoliation glaucoma. Significant differences in glaucoma subtypes, age, pre-operative IOP, pre-operative medications, pre-operative visual acuity, and proportion of phacotrabeculectomy were observed. There were 31 (2.6%) intra-operative complications. The most frequent complications were failure of conjunctival closure, hyphema, and phacoemulsification-related complications. The cumulative incidence of intra-operative complications was significantly different among glaucoma subtypes. Conclusions: Subjects in Japan who underwent MMC-trabeculectomy were predominantly advanced cases. Patient background characteristics and complications were different between glaucoma subtypes.