Low-Dosage Mitomycin C as an Adjunct to Trabeculectomy. A Prospective Controlled Study

Abstract

Mitomycin C is a useful adjunct to glaucoma surgery. Adverse effects at the dosage used are mainly due to hypotony and are preventable with two-layer suture. Low-dose mitomycin C may be useful in standard primary trabeculectomy.

Primary Open-Angle Glaucoma Preferred Practice Pattern® Guidelines

“…The use of intraoperative-MMC reduces the risk of surgical failure both in eyes at high risk of surgical failure 389,390 and in eyes that have not undergone previous surgery. [390][391][392][393] Some studies have demonstrated a benefit of intraoperative 5-fluorouracil 394,395 and others have not. 396 Intraoperative 5-fluorouracil and MMC were found to be equally safe and effective adjuncts to primary trabeculectomy in a multicenter randomized clinical trial.…”

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

“…In routine clinical practice antifibrotic agents such as mitomycin C (MMC) or 5-fluorouracil are used during or after surgery to prevent postoperative scarring [3,4,5,6]. Though MMC and 5-fluorouracil cause widespread cell death and apoptosis, the risk profile seems moderate.…”

A prospective randomised trial of trabeculectomy using mitomycin C vs an ologen implant in open angle glaucoma

“…1 Adjunctive anti-fibrotic agents such as 5-fluorourail or mitomycin C (MMC) have a potent inhibitory effect on postoperative scarring and a positive effect on surgical success rates. 2,3 Although the risk profile of additional use of MMC in trabeculectomy appears low, some side effects such as cataract formation, avascular filtering blebs, thinning of the conjunctiva, subsequent blebitis, and endophthalmitis have been described. [3][4][5][6] Recently, tissue-engineered biodegradable implants have been created as an alternative augmentation in trabeculectomy.…”