Mitomycin C in anterior chamber tube shunt to a surgical membrane

To increase the success rate of intraocular pressure control in recalcitrant glaucoma, anterior chamber tube shunt to a surgical membrane (ACTSSM) surgery using silicone tube and expanded polytetrafluoroethylene (e-PTFE) can be performed. Applying mitomycin C (MMC) during ACTSSM surgery may increase the success rate by decreasing the fibroblast proliferation and collagen in the fibrous capsule. To evaluate the effects of MMC on the fibrous capsule formed after ACTSSM surgery, operations were performed on 18 white rabbits. Nine rabbits were treated with 0.04% MMC solution on the episclera for 5 minutes before ACTSSM (group A) and the others were not treated (group B). At postoperative 2, 4 and 8 weeks successively, 6 eyes of the 3 rabbits were enucleated from each group. Light microscopic examinations were performed after hematoxylin & eosin staining and Masson's trichrome staining. In group A (MMC application group), fibrous capsules were not so dense, moderately thick, and showed many microcystic spaces. Proliferating fibrous connective tissues ingrowing between twofold surgical membranes were scanty. In group B (MMC non-application group), fibrous capsules showed high cellular density and less microcystic spaces, comparing those of MMC application group, suggesting low permeability of fibrous capsule to aqueous humor. MMC may be useful in increasing the success rate of ACTSSM surgery.