suggested mechanism of the ocular hypotensive effect of mitomycin during glaucoma surgery

ABSTRACT

Mitomycin is an antibiotic-antimetabolite, used topically or subconjunctivally, as adjunct chemotherapy during selected cases of glaucoma filtering surgery to promote lowering of intraocular pressure [IOP]. In normal eyes of anesthetized spontaneously breathing rabbits, subconjunctival mitomycin was found to be devoid of any significant effect on IOP, while intravenous injection of the same drug elicited a delayed statistically significant drop of IOP. No change in blood pressure was noticed after subconjunctival or intravenous mitomycin. A potent antiproliferative effect on subconjunctival fibroblasts was proved to promote drop in IOP with intraoperative application of mitomycin. The initial sharp drop in IOP seen postoperatively could, according to this work, be explained by a possible intravenous absorption of the drug from the traumatized local vasculature of the eye occurring during surgical procedures