Mitomycin C in Ahmed Glaucoma Valve Implant Affects Surgical Outcomes

Abstract

Glaucoma is the leading cause of irreversible blindness worldwide, and the Ahmed Glaucoma Valve (AGV) implant is one of the most commonly performed surgeries to prevent glaucoma-related visual impairment. Mitomycin C is an anti-fibrotic agent that may prevent failure of AGV. This is a retrospective case–control study to evaluate surgical outcomes for patients undergoing AGV with adjunct mitomycin C (MMC) injections compared to those without MMC. Among the 142 eyes, 50 received adjunct MMC compared to 92 without MMC injections. IOPs at post-operative months 1, 3, and 6 were significantly lower in the MMC eyes (9.40, 12.01, 12.63 mmHg) compared to the No-MMC eyes (16.86, 15.87, 15.65 mmHg; p < 0.01). The number of post-operative glaucoma medications for the MMC group was lower at 1, 3, and 6 months (0.3, 0.4, 0.59) compared to the No-MMC group (0.7, 0.97, 1.05; p < 0.05). The difference in IOP and the number of medications was not statistically significant by 12 months. Adjunct MMC was associated with more transient hypotony but no long-term complications. These findings suggest that adjunct MMC improves short-term but not long-term surgical outcomes in AGV glaucoma implants.