Abstract
INTRODUCTION AND IMPORTANCE: Congenital glaucoma poses a complex surgical challenge. Mitomycin-C (MMC) is frequently used to enhance surgical success, though the optimal method of application remains debated. CASE PRESENTATION: We present a pediatric case of bilateral congenital glaucoma where two different MMC application methods were used: subconjunctival injection in one eye and sponge application in the other. CLINICAL DISCUSSION: Despite initial IOP reduction in both eyes, the eye treated with sponge application showed progressive bleb thinning and compromise. The subconjunctival injection resulted in a stable, diffuse bleb with better long-term outcomes. CONCLUSION: This case provides comparative intra-patient evidence favoring subconjunctival injection for improved bleb morphology and stability in pediatric glaucoma.