Limbal stem cell deficiency after subconjunctival mitomycin C injection for trabeculectomy

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Ocular Surface Disease

Background:

• Trabeculectomy is a common glaucoma surgery.
• Mitomycin C is used to enhance surgical outcomes.
• Potential complications of mitomycin C require investigation.

Purpose of the Study:

• To report severe limbal stem cell insufficiency following trabeculectomy with subconjunctival mitomycin C.
• To evaluate the safety and efficacy of subconjunctival mitomycin C in glaucoma surgery.

Main Methods:

• Interventional case series of seven patients undergoing trabeculectomy with subconjunctival mitomycin C.
• Mitomycin C (0.1-0.2 ml, 0.2 mg/ml) injected at the 12 o'clock position.

Main Results:

• 43% of patients (3 eyes) with follow-up >1.5 years developed ocular surface issues, including corneal thinning and scleral melting.
• 57% of patients (4 eyes) with follow-up <14 months showed no mitomycin-related complications.

Conclusions:

• Limbal stem cell deficiency is a potential late complication of subconjunctival mitomycin C.
• Subconjunctival mitomycin C injection should be avoided in routine glaucoma filtering surgery.