Intraoperative Mitomycin C for glaucoma surgery

Wilkins, Mark R; Indar, Andrea; Wormald, Richard

doi:10.1002/14651858.cd002897.pub2

Cited by 186 publications

(85 citation statements)

References 36 publications

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“…As described above, antimetabolites such as MMC or 5-fluorouracil are used in routine clinical practice to inhibit increased wound healing and enhance surgical success rates. The use of antimetabolites in trabeculectomy can lead to some serious side effects such as thinning of the conjunctiva, late leakage of the filtering bleb with subsequent endophthalmitis, and cataract formation [8,19,20,21]. The focus of current research is the development of agents that are less toxic but as effective as the antimetabolites.…”

Section: Discussionmentioning

confidence: 99%

Trabeculectomy Using Mitomycin C versus an Atelocollagen Implant: Clinical Results of a Randomized Trial and Histopathologic Findings

et al. 2013

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Purpose: To assess the efficacy of trabeculectomy with a biodegradable Ologen™ implant (OLO) versus mitomycin C (MMC) in patients in a prospective randomized clinical trial. Methods: In the MMC group (15 patients), trabeculectomy was performed according to standard protocols. In the OLO group (15 patients) after standard trabeculectomy, the implant was positioned on top of the scleral flap, and no MMC was applied. Results: Mean preoperative intraocular pressure (IOP) levels (OLO: 28.0 ± 9.4; MMC: 23.9 ± 5.0 mm Hg; p = 0.21) and medication score (OLO: 3.4 ± 1.6; MMC: 3.6 ± 1.5; p = 0.56) were comparable in both groups. One year after surgery, the mean IOP was 15.9 ± 4.5 mm Hg in the OLO group (p < 0.01, 43% reduction) and 11.0 ± 2.6 mm Hg in the MMC group (p < 0.01, 54% reduction). The surgical success rate 12 months after surgery was 93.3% in the MMC group and 40% in the OLO group (p = 0.01). Conclusions: With the atelocollagen-glycosaminoglycan matrix OLO it was not possible to reach the surgical success rate and pressure reduction achieved in the MMC group.

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Section: Discussionmentioning

confidence: 99%

Trabeculectomy Using Mitomycin C versus an Atelocollagen Implant: Clinical Results of a Randomized Trial and Histopathologic Findings

et al. 2013

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“…Trabeculectomy and MMC [7] have been increasingly used in the management of difficult glaucomas, e.g. in young patients [9], black race [10], prior topical anti-glaucomatous medication [11], previous intraocular operations [12], aphakia [13], angle recession [14], uveitis [15][16][17], rubeosis [18] and angle-closure glaucoma [19].…”

Section: Discussionmentioning

confidence: 99%

“…A recent review on the subject, based on a systematic search of various databases, confirms that mitomycin C, administered intraoperatively, reduces the risk of surgical failure, reduces mean intraocular pressure at 12 months and leads to no demonstrable significant increase in side effects [7].…”

Section: Introductionmentioning

confidence: 99%

Long-term results of trabeculectomy with mitomycin C applied under the scleral flap

et al. 2007

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“…106 MMC is preferentially used as the intraoperative antifibrotics, more than twice as often as 5-FU, 60 and has been validated by Cochrane meta-analysis to reduce significantly the IOP and the risk of surgical failure in eyes that have undergone no previous surgery and in eyes at high risk of failure. 120 Despite their efficacy in reducing post-operative scarring, 67 however, anti-metabolites are associated with complications such as hypotony with maculopathy, cystic avascular bleb, bleb leak, bleb infection, and endophthalmitis. 39,53,95 …”

Section: Therapy In Glaucoma Filtration Surgerymentioning

confidence: 99%

Angiogenesis in glaucoma filtration surgery and neovascular glaucoma: A review

Kim

Lee

Payne

et al. 2015

Survey of Ophthalmology

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Angiogenesis may pose a clinical challenge in glaucoma, for example during the wound healing phase after glaucoma filtration surgery and in a severe form of secondary glaucoma called neovascular glaucoma (NVG). Up regulation of vascular endothelial growth factor (VEGF), a key mediator of angiogenesis, occurs in eyes that have undergone glaucoma filtration surgery, as well as those with NVG. This has led to studies investigating the ability of anti-VEGF therapy to improve outcomes, and we examine their findings with respect to the safety and efficacy of anti-VEGF agents, mainly bevacizumab and ranibizumab, in eyes that have undergone glaucoma filtration surgery or have NVG. Combining conventional therapies—such as anti-metabolites after filtration surgery and panretinal photocoagulation in NVG—and anti-VEGF drugs may achieve a synergetic effect, although further studies are required to evaluate the long-term efficacy of combination treatments.

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Intraoperative Mitomycin C for glaucoma surgery

Cited by 186 publications

References 36 publications

Trabeculectomy Using Mitomycin C versus an Atelocollagen Implant: Clinical Results of a Randomized Trial and Histopathologic Findings

Trabeculectomy Using Mitomycin C versus an Atelocollagen Implant: Clinical Results of a Randomized Trial and Histopathologic Findings

Long-term results of trabeculectomy with mitomycin C applied under the scleral flap

Angiogenesis in glaucoma filtration surgery and neovascular glaucoma: A review

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