Protocol for mitomycin C use in glaucoma surgery.

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Pharmacology

Background:

• Trabeculectomy and combined phacoemulsification-trabeculectomy are standard glaucoma surgeries.
• Mitomycin C (MMC) is an antifibrotic agent used to enhance surgical success.
• Optimizing MMC concentration is crucial for balancing efficacy and safety.

Purpose of the Study:

• To evaluate the efficacy and safety of a specific protocol for mitomycin C (MMC) application in trabeculectomy and combined surgeries.
• To determine if varying MMC concentrations (0.1, 0.2, 0.4 mg/ml) affect surgical outcomes.
• To assess the impact of MMC on intraocular pressure (IOP) control and postoperative complications.

Main Methods:

• A prospective study involving 143 eyes of 124 patients undergoing glaucoma surgery.
• Patients were divided into four groups: no MMC, 0.1 mg/ml MMC, 0.2 mg/ml MMC, and 0.4 mg/ml MMC, with a 2-minute application time.
• Intraocular pressure (IOP) and complications were evaluated at 1-year follow-up. Successful IOP control was defined as <21 mmHg, or <16 mmHg for advanced glaucoma.

Main Results:

• Mean preoperative IOP of 24.60 mmHg decreased significantly to 13.47 mmHg at 12 months postoperatively (p < 0.00001).
• Overall IOP control was achieved in 79.02% of eyes.
• No statistically significant differences in final mean IOP or postoperative complications were observed among the groups using MMC (p > 0.120).

Conclusions:

• The described protocol for mitomycin C (MMC) use in glaucoma surgery is effective in lowering IOP.
• Different concentrations of MMC (0.1, 0.2, 0.4 mg/ml) did not yield significant differences in IOP control or complication rates.
• The study suggests that a range of MMC concentrations can be effectively selected based on clinical presentation without compromising outcomes.