Late Argon Laser Suture Lysis after Mitomycin C Trabeculectomy

Background: Argon laser suture lysis has been effectively used in the early postoperative period to enhance filtration after trabeculectomy. The most substantial reductions in intraocular pressure (10P) occur when laser suture lysis is performed during the first 2 postoperative weeks, and virtually no effect has been reported after the fourth postoperative week. Mitomycin C, used as adjunct therapy, improves the success rate of trabeculectomy in high-risk eyes and may change the time course for effective suture lysis. Methods: The authors used late laser suture lysis in five high-risk patients after mitomycin C trabeculectomy. The mean patient age was 66.8 ± 15.7 years, and laser suture lysis was performed an average of 13 ± 5.8 weeks (range, 7-21 weeks) after surgery. Results: The mean 101? before suture lysis was 20.2 ± 3.8 mmHg. The average 101? reduction immediately after suture lysis was 11.4 ± 3.9 mmHg. The average IOP 3 to 4 months after laser suture lysis was 9.4 ± 3.4 mmHg. Conclusions: The authors postulate that,adjunctive mitomycin C therapy markedly delays wound healing and appears to extend the period that laser suture lysis is clinically effective.