In vitro mitomycin C absorption and delivery with different sponge materials used in filtering surgery

Abstract

PurposeThe purpose of this study is to evaluate and compare mitomycin C (MMC) absorption and delivery in different materials used in filtering surgery.MethodsThis is an in vitro study comparing polyvinyl alcohol triangular sponges (TS6, TS8), polyvinyl alcohol fluid wicks (EFW), and absorbable gelatin sponges (AGS3, AGS5), from which five different types of transport units were obtained. Seven pieces of sponge of each transport unit type were obtained as follows: two transverse strips were obtained at 6 and 8 mm from the apex of TS and divided into three equal pieces; 4×4 mm pieces of EFW; 3×3 and 5×5 mm pieces of absorbable gelatin sponges were cut. Filter paper was placed on a precision scale (0.01 mg). The seven sponge pieces of each type were weighed three times consecutively in dry and wet states, the latter after immersion for 15 seconds in 0.2 mg/mL MMC. The difference between the weights of the dry and wet filter paper at the end of each measurement sequence was also calculated and considered as an estimate of the amount of mitomycin delivered.ResultsThe amounts of MMC absorbed by each transport unit were as follows: (mean ± standard deviation) 27.43±5.13 for TS6, 31.91±6.63 for TS8, 15.96±2.23 for EFW, 17.96±2.05 for AGS3, and 33.81±2.05 for AGS5. The amounts of MMC delivered to the filter paper were as follows: 21.70±2.84 for TS6, 23.83±4.03 for TS8, 12.93±1.75 for EFW, 14.69±1.79 for AGS3, and 27.30±1.58 for AGS5.ConclusionPercentage MMC delivered was similar for all materials, but there was a tendency for greater delivery using larger sponges and greater homogeneity in delivery with AGS5. No statistical differences were found in percentage delivered by the different transport materials.

A unique shape of scleral flap to increase surgical success rate in mitomycin C-augmented trabeculectomy: a 1-year study

“…MMC is thus initially applied as an anti brotic agent via soaked sponges [8]. In our study, gelatin sponges were used to deliver a more reproducible drug solution weight compared to the polyvinyl alcohol sponges [20]. In addition, we created a fornix-based conjunctival incision wound with a 10-15 mm pocket to apply posterior advancement of the soaked sponges as advised by Dr. Khaw in his Moor elds Safer Surgery System, to cover the largest possible area [12].…”

Adjunctive Antifibrotic Therapy with Mitomycin C and 5-Fluorouracil: A Review of their use in Glaucoma Surgery and Considerations around Ophthalmic Compounding

“…MMC is widely used in glaucoma filtration surgery to prevent scarring in the subconjunctival space [31] and it is now approved by FDA for use as an adjunct [23,35] for application with a topical sponge. Its use in conjunctival neoplasm's is secondary to glaucoma filtration [36], and efficacy is highly associated with concentration and application time used [37,38], as well as patient and surgical variables [39].…”