Trabeculectomy with mitomycin C versus Ahmed glaucoma implant with mitomycin C for treatment of pediatric aphakic glaucoma.

PURPOSE: To compare trabeculectomy with mitomycin C (T+MMC) and Ahmed glaucoma implant with MMC (AGI+MMC) in treatment of aphakic glaucoma in children below 16 years of age.

DESIGN

Randomized clinical trial.

PARTICIPANTS

Subjects less than 16 years of age who had previously undergone anterior lensectomy and vitrectomy for treatment of congenital cataract with unresponsive aphakic glaucoma (at least on 2 medications) were allocated in 2 groups: trabeculectomy with MMC (group A, 15 eyes) and AGI (group B, 15 eyes).

METHODS

Fifteen eyes in each group underwent T+MMC or AGI+MMC. Complete and qualified success were defined as 5< or =intraocular pressure< or =21 mm Hg without and with medication, respectively.

MAIN OUTCOME MEASURES: Intraocular pressure, visual acuity, and complications.

RESULTS

Complete and qualified success rates were 33.3% and 40% in T+MMC group versus 20% and 66.7% in AGI+MMC group, respectively (P=0.36). Mean follow-up was 14.8 and 13.1 months and complication rates were 40% and 26.7% (P=0.44), respectively.

CONCLUSIONS

T+MMC and AGI+MMC are comparable in terms of success rate and complications in pediatric aphakic glaucoma.

PRECIS: This randomized clinical trial demonstrated comparable safety and efficacy for MMC trabeculectomy and AGI in the treatment of pediatric aphakic glaucoma.