Effects of Topical Mitomycin C on Glaucoma Filtration Surgery

ABSTRACT

We studied the efficacy and safety of using topical mitomycin C(MMC) as an adjunct to glaucoma filtration surgery. Trabeculectomy was performed in 23 eyes of 19 patients with poor surgical prognosis. After the preparation of a scleral flap. 0.2mg or 0.4 mg/ml MMC was applied to the exposed tissue for 5 minutes. The wound was then irrigated with 250ml of normal saline. The follow-up period was from 2 to 12 months(mean 7.8 +/- 4.3 months). Preoperative mean intraocular pressure(IOP) was 33.8 +/- 7.1 mmHg, ranged from 25 to 51 mmHg. The mean IOPs after 1, 3, 6 and 12 months were 10.3 +/- 4.4, 12.5 +/- 6.9, 12.4 +/- 6.6 and 12.3 +/- 6.7 mmHg, respectively. Nineteen(82.6%) among 23 eyes were successfully controlled with the IOP below 20 mmHg without any antiglaucomatous therapies, and success rate was 0.747 by Kaplan-Meier method at Postoperative 12 months. There were early postoperative complications of aqueous leaking from conjunctival wound in 3 eyes(13.0%), shallow anterior chamber in 2 eyes, and hyphema in one eye and one eye had long-term hypotony lasting more than 3 months. Although MMC is simple to use and a potent adjunct to glaucoma filtration surgery, more work will be needed to determine the mechanism of action, indications, dosage and optimal exposure time of MMC.