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Related Experiment Videos

Preoperative mitomycin-C subconjunctival injection and glaucoma filtering surgery

P T Hung1, L L Lin, J W Hsieh

  • 1Department of Ophthalmology, National Taiwan University, Taipei, Republic of China.

Journal of Ocular Pharmacology and Therapeutics : the Official Journal of the Association for Ocular Pharmacology and Therapeutics
|January 1, 1995
PubMed
Summary

Preoperative subconjunctival mitomycin-C injections before glaucoma surgery significantly reduce intraocular pressure (IOP). This method offers a safe and effective alternative for managing refractory glaucoma patients.

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Area of Science:

  • Ophthalmology
  • Surgical Innovation
  • Glaucoma Research

Background:

  • Intraoperative mitomycin-C enhances glaucoma surgery but has variable ocular tissue concentrations.
  • Uncertain residual mitomycin-C levels raise concerns about potential long-term ocular toxicity.
  • Previous rabbit studies showed promise for preoperative mitomycin-C subconjunctival injections.

Purpose of the Study:

  • To evaluate the efficacy and safety of preoperative subconjunctival mitomycin-C injections in glaucoma patients.
  • To assess intraocular pressure (IOP) control and clinical outcomes following this adjunctive procedure.
  • To determine the benefits of this approach for refractory and high-risk glaucoma cases.

Main Methods:

  • Six eyes of six refractory glaucoma patients received subconjunctival mitomycin-C (1.2–3.6 micrograms) 24–72 hours before limbal-based trabeculectomy.

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  • Initial successful case followed by five additional eyes with a minimum five-month follow-up.
  • Clinical observation focused on IOP, bleb appearance, and overall clinical course.

    • Main Results:

    • Average preoperative IOP of 27.8 mm Hg (range 24–34 mm Hg) was reduced to 9.5 mm Hg (range 5–14 mm Hg) postoperatively.
    • A smooth clinical course was observed in all treated eyes.
    • Satisfactory IOP control and functioning bleb appearance were noted during follow-up periods.

    Conclusions:

    • Preoperative subconjunctival mitomycin-C injection is an effective adjunctive method for enhancing IOP control in glaucoma surgery.
    • This technique provides a predictable dose and potentially reduces long-term toxicity concerns associated with intraoperative application.
    • The study emphasizes the advantages of this modified approach for managing complex glaucoma cases.