Yuasa Y, Sugimoto Y, Hirooka K, et al. - Researchers investigated the efficacy and safety of current trabeculectomy with mitomycin C in Japan for glaucomatous eyes with low intraocular pressure (IOP). From the Collaborative Bleb-related Infection Incidence and Treatment Study, a multicentre, prospective, cohort study conducted at 34 ophthalmological institutions throughout Japan, yielded data of 294 eyes of 294 patients with IOP ≤ 21 mmHg before surgery. The use of two success criteria was made: Criterion A included 20% decline of baseline IOP and Criterion B included 30% decline of baseline IOP. The qualified success rates were 87.3% and 42.0% for Criterion A and Criterion B at 5 years, respectively. A significant reduction in the mean IOP was observed, from 16.7 ± 2.7 to 11.6 ± 4.0 mmHg at 5 years after trabeculectomy; a significant decrease in the number of anti-glaucoma medications significantly decreased was noted from 2.7 ± 1.1 to 1.0 ± 1.2 at 5 years after the surgery. Findings thereby support trabeculectomy with mitomycin C as an effective procedure with few surgical complications for reducing IOP in patients. Its efficacy was evident even when preoperative IOP was within the normal range.