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Updated: Jun 23, 2026

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Histopathology of a functioning mitomycin-C trabeculectomy.

Steve Y-W Liang1, Graham A Lee, Kevin Whitehead

  • 1City Eye Centre, Brisbane, Queensland, Australia.

Clinical & Experimental Ophthalmology
|May 23, 2009
PubMed
Summary

Mitomycin-C trabeculectomy can preserve normal conjunctival architecture. Careful use of this anti-metabolite helps avoid altered histopathology and hypotony in glaucoma surgery.

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Area of Science:

  • Ophthalmology
  • Glaucoma Surgery
  • Histopathology

Background:

  • Trabeculectomy is a common glaucoma surgery.
  • The ideal bleb morphology is diffuse, normally vascularized, and microcystic.
  • Mitomycin-C is an anti-metabolite used to augment trabeculectomy.

Observation:

  • Histopathological examination of a normally functioning mitomycin-C trabeculectomy site was performed.
  • The conjunctiva showed a uniform stratified squamous epithelium and oedematous basal cells.
  • The conjunctival stroma had loose connective tissue, capillaries, and small cystic spaces.

Findings:

  • The scleral trapdoor was evident as a cleft connecting to the anterior chamber.
  • The conjunctiva lacked goblet cells and had few inflammatory cells and fibroblasts.

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  • Histopathological findings correlated with the clinical appearance of a normal bleb.

    • Implications:

    • Careful use of mitomycin-C can conserve normal conjunctival architecture during trabeculectomy.
    • Altered histopathology and hypotony can occur with anti-metabolite augmentation.
    • Understanding bleb histopathology is crucial for successful glaucoma surgery outcomes.