LONG-TERM SUCCESS OF MITOMYCIN- AUGMENTED TRABECULECTOMY FOR GLAUCOMA AFTER VITREORETINAL SURGERY WITH SILICONE OIL INSERTION A Prospective Case Series DIGVIJAY SINGH, MD, ANURADHA CHANDRA, MS, RAMANJIT SIHOTA, MD, FRCS, SANDIP KUMAR, B OPTOM, VINEY GUPTA, MD Purpose: To evaluate the long-term success of trabeculectomy with mitomycin C for glaucoma after vitreoretinal surgery with silicone oil insertion. Methods: Prospective evaluation of patients who underwent trabeculectomy with mitomycin C (superior or inferior site) for glaucoma after vitreoretinal surgery. Parameters examined included intraocular pressure (IOP), visual acuity, and glaucomatous neuropathy status, preoperatively and at multiple follow-up visits postoperatively till 12 months. Success, both absolute (IOP ,21 mmHg) and qualified (IOP ,21 mmHg with the use of medications and/or needling), was determined at each follow-up visit. Results: Nineteen patients with mean age of 29 ± 16 years had a mean untreated baseline IOP of 42.5 ± 10.66 mmHg, which reduced to 23.82 ± 7.58 at 1 year (P = 0.008). Preoperative decimal visual acuity was 0.12 ± 0.21, which worsened to 0.07 ± 0.08 at the final follow-up (P = 0.81). Total success rate was 36.9% at the end of 1 year, whereas absolute success rate was only 15.8%. Duration between vitreoretinal surgery and silicone oil removal, preoperative IOP, or site of surgery did not determine success rate. Conclusion: Twelve-month success rate for trabeculectomy with mitomycin C in glaucoma after vitreoretinal surgery with silicone oil insertion is lower than reported for most refractory glaucomas. RETINA 34:123–128, 2014 G laucoma is an established complication after vit- reoretinal surgery, particularly in eyes filled with silicone oil. Silicone oil was reported to be a cause for glaucoma in the silicone oil study where 8% of oil filled eyes had shown chronically high intraocular pres- sure (IOP). 1 Subsequent literature has documented sig- nificantly high IOP in 20% to 60% of oil-filled eyes after vitreoretinal surgery, although the incidence of glaucomatous neuropathy was lower. 2–4 High IOP may be directly attributed to silicone oil in nearly 70% of the cases of postvitreoretinal surgery glau- coma. 3 High IOP secondary to intraocular silicone oil is often resistant to therapy and has been shown to require surgical intervention such as silicone oil removal or glaucoma surgery in about 40% of the eyes. 3,5 Trabeculectomy in eyes previously subjected to vitreoretinal surgery and filled with silicone oil may have a poorer prognosis, and up to a third of silicone oil filled eyes may be refractory to treatment. 3 Factors deemed to cause poorer control include the presence of emulsified oil and diabetes. 3 There are a few short-term studies and one retrospective study mentioning qualified success after trabeculectomy in oil-induced glaucoma eyes. 3,5,6 However, there are no From the Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sci- ences, New Delhi, India. None of the authors have any financial/conflicting interests to disclose. Reprint requests: Viney Gupta, MD, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Room No. 472, Ansari Nagar, New Delhi 110029, India; e-mail: gupta_v20032000@yahoo.com 123