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History, presence, and future of mitomycin C in glaucoma filtration surgery

Jarno E J Wolters1,2,3, Ralph J S van Mechelen1,2,3, Rana Al Majidi1,2,3

  • 1University Eye Clinic Maastricht, Maastricht University Medical Centre + (MUMC+), Maastricht.

Current Opinion in Ophthalmology
|December 14, 2020
PubMed
Abstract

Insights

Mitomycin C (MMC) improves glaucoma filtration surgery (GFS) success by reducing scarring. Prolonging MMC delivery via drug systems may further enhance GFS outcomes and prevent surgery failure.

Area of Science:

  • Ophthalmology
  • Surgical Oncology
  • Pharmacology

Background:

  • Mitomycin C (MMC) is an alkylating agent used as an antitumor drug and the gold standard for glaucoma filtration surgery (GFS).
  • GFS aims to lower intraocular pressure by creating an aqueous humor (AqH) drainage pathway.
  • Fibrosis and scarring in the sub-Tenon's space are primary causes of GFS failure.

Observation:

  • Intraoperative MMC application enhances GFS success rates, primarily by mitigating post-surgical fibrosis.
  • Despite its efficacy, approximately 10% of GFS procedures fail within the first year.

Findings:

  • This review evaluates the risks and benefits of using MMC as an adjuvant in GFS.
  • Potential improvements include optimizing MMC dosage and administration methods.
  • Prolonged MMC delivery using drug delivery systems is a promising strategy to improve GFS outcomes.

Implications:

  • Enhanced drug delivery systems could lead to more successful glaucoma surgeries.
  • Further research into MMC administration may reduce long-term GFS failure rates.
  • Optimizing MMC use can improve patient outcomes in glaucoma management.

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