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Glaucoma is defined as a chronical progressive optical neuropathy with morphological (excavation of the optic nerve head) and functional disturbances (defects in the field of vision). According to the WHO data 60 million people have been diagnozed with glaucoma worldwide, 4 million of whom are blind. Clinical glaucoma is classified as: primary, secondary and congenital. Intraocular pressure (IOP) is the fluid pressure inside the eye. Normal IOP is between 10 and 22 mmHg. It depends on the homeostasis between production and elimination of eye fluid. There are three mechanisms for production of eye fluid: diffusion, ultrafiltration and active secretion. Primary open angle glaucoma or simplex glaucoma develops due to slow clogging of drainage channels in the wall of the angle. Primarily, the normal ability of the eye to eliminate more than 2.2 microliters of fluid per minute is reduced. Risk factors for open angle glaucoma include: raised intraocular pressure, age of the patient, positive family history, race, central cornea thickness, pseudoexfoliation, miopia and vascular factors (local and systemic). Raised intraocular pressure is still considered to be the most important risk factor for glaucoma development.

Background/Aim. Different surgical interventions have been proposed, including trabeculectomy associated with antiproliferative agents because silicone oil (SO) removal cannot necessarily provide intraocular pressure (IOP) control. The aim of the study was to determine the efficacy of trabeculectomy with mitomycin C (MMC) for lowering IOP in patients with open-angle glaucoma (OAG) secondary to emulsified SO after pars plana vitrectomy. Methods. A single-center, prospective study was conducted, from December 2014 to December 2019, on 56 consecutive patients with an uncontrolled elevation of IOP after SO removal who were subjected to trabeculectomy with mitomycin MMC in that period. The primary end-point was the IOP at the three-year follow-up visit. Complete surgical success was defined as an IOP ranging from 7 mmHg to 18 mmHg without glaucoma medication. Qualified success was defined as I OP = 2 1 m mHg with one or two topical medications. Results. Fifty-six patients with a mean age of 5 3.6 [standard deviation (SD)15.5] years had a mean baseline IOP of 42.3 (39.3 to 45.3) mmHg, which reduced to 18.6 (17.9 to 19.3) mmHg three years after surgery (p < 0.0001). Seventeen (30.4%) eyes were classified as a complete success, 21 (37,5%) as a qualified success, and 18 (32.1%) as a failure. In all successfully treated patients, the number of antiglaucoma medications was significantly reduced from 2.85 (SD 0.77) to 1.63 (SD 0.62), p < 0.0001. Conclusion. Trabeculectomy with MMC may be an option for lowering IOP in patients with OAG secondary to emulsified SO after pars plana vitrectomy, which was not controlled with maximum antiglaucomatous medical treatment. [ABSTRACT FROM AUTHOR]