Complicações do uso intra-operatório de mitomicina-C em trabeculectomias

Lauande-Pimentel, Roberto; Santos, Roberto Oliveira; Dantas, Marcos Antônio; Amaral Filho, José Maria do; Costa, Vital Paulino; José, Newton Kara

doi:10.5935/0004-2749.19980055

RESUMO

Objetivo: Avaliar a freqüência de complicações decorrentes do uso intra-operatório de mitomicina-C em trabeculectomias.

Materiais e Métodos: Foram analisados 76 olhos submetidos à cirurgia filtrante com mitomicina-C, notando-se diagnóstico, indicação para seu. uso, medidas de pressão intra-ocular, número de medicações antiglaucomatosase complicações no período pós-operatório.

Resultados: Esta série mostrou incidência de 25% de câmara anterior rasa, 18,4% de hiperflltração, 10,5% de catarata e 9,2% de descolamento decoróide.

Conclusões: O presente estudo sugere que a mitomicina-C deve ser utilizada com bastante critério e cautela pelo oftalmologista, tendo em vista as complicações potencialmente graves que podem dela advir.

Palavras-chave:
Mitomicina-C; Trabeculectomia; Glaucoma

SUMMARY

Purpose: To evaluate the frequency of complications related to the intraoperative use of mitomycin C in trabeculectomies.

Methods: The authors studied 76 eyes submitted to a filtering procedure with mitomycin C. The intraocular pressure measurements, number of antiglaucomatous medications per patient and postoperative complications of all 76 patients were analyzed.

Results: This series showed an incidence of 25% of shallow anterior chamber, 18.4% of overfiltration, 1O. 5% of cataract formation and 9.2°% of choroidal detachment.

Conclusions: The present study suggests that mitomycin C must be cautiously used by ophthalmologists, as related complications can be potentially serious.

Keywords:
Mitomycin C; Trabeculectomy; Glaucoma

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REFERÊNCIAS BIBLIOGRÁFICAS

¹ Rockwood EJ, Parrish RKII, Heuer DK et al. Glaucoma filtering surgery with 5-fluorouracil. Ophthalmology 1987;94:1071-78.
² Skuta GL, Beeson CC, Higginbotham EJ et al. Intraoperative mitomycin versus postoperative 5-fluorouracil in high-risk glaucoma filtering surgery. Ophthalmology 1992;99:438-44.
³ Zacharia PT, Deppermann SR, Schuman JS. Ocular Hypotony after trabeculectomy with mitomycin C. Am J Ophthalmol 1993;116:314-26.
⁴ Shields MB, Scroggs MW, Sloop CM, Simmons RB. Clinical and histopathologic observations concerning hypotony after trabeculectomy with adjunctive mitomycin C. Am J Ophthalmol 1993;116:673-83.
⁵ Costa VP, Wilson RP, Moster MR et al. Hypotony Maculopathy Following the Use of Topical Mitomycin C in Glaucoma Filtration Surgery. Ophthalmic Surgery 1993;24:389-94.
⁶ Cairns JE. Trabeculectomy. A surgical method of reducing intra-ocular pressure in chronic simple glaucoma without subconjuntival drainage of aqueous humor. Trans Ophthalmol Soc U-K. 1969;88:231-3.
⁷ The Fluorouracil Filtering Surgery Study Group. Fluorouracil Filtering Surgery Study one-year follow-up. Am J Ophthalmol 1989;108:625-35.
⁸ Liebmann JM, Ritch R, Marmor M et al. Initial 5-fluorouracil trabeculectomy in uncomplicated glaucoma. Ophthalmology 1991;98:1036-41.
⁹ Rubinfeld RS, Pfister RR, Stein RM et al. Serious complication of topical mitomycin C after pterygium surgery. Ophthalmology 1992;99:1647-54.
¹⁰ Chen CW. Enhanced intraocular pressure controlling effectiveness of trabeculectomy by local application of mitomycin C. Trans Asia-Pacific Acad Ophthalmol 1983;9:172-7.
¹¹ Yamamoto T, Varani J, Soong HK, Lichter PR. Effect of 5-fluorouracil and mitomycin C on cultured rabbit subconjunctival fibroblast. Ophthalmology 1990;97:1202-10.
¹² Palmer SS. Mitomycin as adjunct chemotherapy with trabeculectomy. Ophthalmology 1991;98:317-21.
¹³ Bergstrom TJ, Wilkinson WS, Skuta GL et al. The effect of subconjunctival mitomycin C on glaucoma filtration surgery in rabbits. Arch Ophthalmol 1991;109:1725-30.
¹⁴ Kitazawa Y, Kawase K, Matsushita H, Minobe M. Trabeculectomy with mitomycin - a comparative study with fluorouracil. Arch Ophthalmol 1991;109:1693-98.
¹⁵ Costa VP, Moster MR, Wilson RP, Schmidt CM et al. Effects of topical mitomycin C on primary trabeculectomies and combined procedures. Br J Ophthalmol 1993;77:693-7.
¹⁶ Costa VP, Comegno PE, Vasconcelos JP, Malta RF, Kara-José N. Low-dose mitomycin C trabeculectomy in patients with advanced glaucoma. J Glaucoma 1996;5:193-9.
¹⁷ Duker JS, Schuman JS. Successful surgical treatment of hypotony maculopathy following trabeculectomy with topical mitomycin C. Ophthalmic Surg 1994;25:463-5.
¹⁸ Costa VP, Smith M, Spaeth GL, Gandham S, Markovitz B. Loss of visual acuity after trabeculectomy. Ophthalmology 1993;100:599-612.
¹⁹ Greenfield OS, Suner IJ, Miller MP, Kangas TA, Palmer PF, Flynn HW. Endophthalmitis after filtering surgery with mitomycin. Arch Ophthalmol 1996;114:943-9.
²⁰ Brown LH et al. Treatment of bleb infection after glaucoma surgery. Arch Ophthalmol 1994;112:57-61.

Datas de Publicação

Publicação nesta coleção
Jun 1998

Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que o trabalho original seja corretamente citado.

[1] ¹ Rockwood EJ, Parrish RKII, Heuer DK et al. Glaucoma filtering surgery with 5-fluorouracil. Ophthalmology 1987;94:1071-78.

[2] ² Skuta GL, Beeson CC, Higginbotham EJ et al. Intraoperative mitomycin versus postoperative 5-fluorouracil in high-risk glaucoma filtering surgery. Ophthalmology 1992;99:438-44.

[3] ³ Zacharia PT, Deppermann SR, Schuman JS. Ocular Hypotony after trabeculectomy with mitomycin C. Am J Ophthalmol 1993;116:314-26.

[4] ⁴ Shields MB, Scroggs MW, Sloop CM, Simmons RB. Clinical and histopathologic observations concerning hypotony after trabeculectomy with adjunctive mitomycin C. Am J Ophthalmol 1993;116:673-83.

[5] ⁵ Costa VP, Wilson RP, Moster MR et al. Hypotony Maculopathy Following the Use of Topical Mitomycin C in Glaucoma Filtration Surgery. Ophthalmic Surgery 1993;24:389-94.

[6] ⁶ Cairns JE. Trabeculectomy. A surgical method of reducing intra-ocular pressure in chronic simple glaucoma without subconjuntival drainage of aqueous humor. Trans Ophthalmol Soc U-K. 1969;88:231-3.

[7] ⁷ The Fluorouracil Filtering Surgery Study Group. Fluorouracil Filtering Surgery Study one-year follow-up. Am J Ophthalmol 1989;108:625-35.

[8] ⁸ Liebmann JM, Ritch R, Marmor M et al. Initial 5-fluorouracil trabeculectomy in uncomplicated glaucoma. Ophthalmology 1991;98:1036-41.

[9] ⁹ Rubinfeld RS, Pfister RR, Stein RM et al. Serious complication of topical mitomycin C after pterygium surgery. Ophthalmology 1992;99:1647-54.

[10] ¹⁰ Chen CW. Enhanced intraocular pressure controlling effectiveness of trabeculectomy by local application of mitomycin C. Trans Asia-Pacific Acad Ophthalmol 1983;9:172-7.

[11] ¹¹ Yamamoto T, Varani J, Soong HK, Lichter PR. Effect of 5-fluorouracil and mitomycin C on cultured rabbit subconjunctival fibroblast. Ophthalmology 1990;97:1202-10.

[12] ¹² Palmer SS. Mitomycin as adjunct chemotherapy with trabeculectomy. Ophthalmology 1991;98:317-21.

[13] ¹³ Bergstrom TJ, Wilkinson WS, Skuta GL et al. The effect of subconjunctival mitomycin C on glaucoma filtration surgery in rabbits. Arch Ophthalmol 1991;109:1725-30.

[14] ¹⁴ Kitazawa Y, Kawase K, Matsushita H, Minobe M. Trabeculectomy with mitomycin - a comparative study with fluorouracil. Arch Ophthalmol 1991;109:1693-98.

[15] ¹⁵ Costa VP, Moster MR, Wilson RP, Schmidt CM et al. Effects of topical mitomycin C on primary trabeculectomies and combined procedures. Br J Ophthalmol 1993;77:693-7.

[16] ¹⁶ Costa VP, Comegno PE, Vasconcelos JP, Malta RF, Kara-José N. Low-dose mitomycin C trabeculectomy in patients with advanced glaucoma. J Glaucoma 1996;5:193-9.

[17] ¹⁷ Duker JS, Schuman JS. Successful surgical treatment of hypotony maculopathy following trabeculectomy with topical mitomycin C. Ophthalmic Surg 1994;25:463-5.

[18] ¹⁸ Costa VP, Smith M, Spaeth GL, Gandham S, Markovitz B. Loss of visual acuity after trabeculectomy. Ophthalmology 1993;100:599-612.

[19] ¹⁹ Greenfield OS, Suner IJ, Miller MP, Kangas TA, Palmer PF, Flynn HW. Endophthalmitis after filtering surgery with mitomycin. Arch Ophthalmol 1996;114:943-9.

[20] ²⁰ Brown LH et al. Treatment of bleb infection after glaucoma surgery. Arch Ophthalmol 1994;112:57-61.

Complicações do uso intra-operatório de mitomicina-C em trabeculectomias

Complications of intraoperative mitomycin C on trabeculectomies

RESUMO

SUMMARY

REFERÊNCIAS BIBLIOGRÁFICAS

Datas de Publicação