The Results of Primary Trabeculectomy with Mitomycin C in Fuchs Uveitis Syndrome-Associated Glaucoma

Purpose To evaluate the efficacy and safety of mitomycin C (MMC)-augmented trabeculectomy in patients with Fuchs uveitis syndrome (FUS)-associated glaucoma.Methods This retrospective study included FUS-associated glaucoma patients with ≥1-year follow-up after trabeculectomy (MMC 0.2 mg/mL, 2 min) for uncontrolled glaucoma despite maximum tolerated medical therapy. Preoperative and postoperative data were collected, including best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of antiglaucoma medications, intraoperative and postoperative complications, and required additional surgical interventions. Postoperative assessments included bleb morphology and the need for reoperation. Success criteria (5 < IOP ≤ 21 mmHg) were categorized as “complete” (without medication/reoperation) or “qualified” (with medication).Results Fifty-seven eyes of 56 patients (mean age 45.4 ± 11.8 years; 61.4% pseudophakic) were enrolled. At a median follow-up of 41 (18–73) months, mean IOP decreased from 31.2 ± 9.2 mmHg to 14.8 ± 5.2 mmHg at the 24-month follow-up (p < 0.001). Medications were reduced from 2.8 ± 0.6 to 1.4 ± 1.5 (p < 0.001). At the 2-year follow-up, complete and qualified success rates were 42.1% and 22.8%, respectively. Reoperation was required in 20 eyes (35%) at a mean of 25.7 ± 26.2 months. Complications included transient hypotony in 8 eyes, with choroidal detachment in 2 eyes. Bleb needling was performed in 22 eyes (38%) at a mean of 16.7 months. The number of preoperative antiglaucoma medications was significantly associated with total surgical success (p < 0.001).Conclusion MMC-augmented trabeculectomy provides effective long-term IOP control and significantly reduces the medication burden in patients with FUS-associated glaucoma. Although postoperative complications and reoperations are not uncommon, favourable surgical outcomes can be achieved.