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Related Experiment Videos

Intra-operative mitomycin C for glaucoma surgery.

M Wilkins1, A Indar, R Wormald

  • 1Moorfields Eye Hospital, City Road, London, UK EC1V 2PD. mail@markwilkins.co.uk

The Cochrane Database of Systematic Reviews
|October 20, 2005
PubMed
Summary
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Mitomycin C (MMC) reduces trabeculectomy failure in first-time surgeries and high-risk eyes, lowering intraocular pressure (IOP). However, long-term risks like infection and increased cataract formation require further study.

Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Glaucoma Treatment

Background:

  • Trabeculectomy is a surgical procedure to reduce intraocular pressure (IOP) in glaucoma patients.
  • Mitomycin C (MMC) is an antimetabolite used to inhibit scarring and prevent trabeculectomy failure.
  • Postoperative scarring is a primary cause of trabeculectomy failure.

Purpose of the Study:

  • To evaluate the efficacy of intraoperative Mitomycin C (MMC) versus placebo in trabeculectomy.
  • To assess the impact of MMC on surgical success rates and intraocular pressure.
  • To identify potential side effects associated with intraoperative MMC use.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials.
  • Searched multiple databases including CENTRAL, MEDLINE, EMBASE, SIGLE, NRR, and LILACS.

Related Experiment Videos

  • Included 11 randomized trials with 698 participants comparing intraoperative MMC to placebo.

    • Main Results:

    • MMC significantly reduced the risk of trabeculectomy failure in eyes with no prior surgery (RR 0.29) and high-risk eyes (RR 0.32).
    • Mean intraocular pressure (IOP) was significantly lower at 12 months in all groups receiving MMC compared to placebo.
    • No significant increase in sight-threatening complications was observed, but long-term risks like bleb infection and endophthalmitis were not adequately assessed. MMC may increase cataract risk.

    Conclusions:

    • Intraoperative MMC is effective in reducing surgical failure and lowering IOP in trabeculectomy for both primary and high-risk cases.
    • While MMC appears safe in the short term, potential long-term risks such as cataract formation warrant further investigation.
    • The current evidence is insufficient to rule out increased risks of endophthalmitis and bleb infections with MMC use.