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Review
. 2021 Mar 1;32(2):148-159.
doi: 10.1097/ICU.0000000000000729.

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

Jarno E J Wolters  1   2   3 , Ralph J S van Mechelen  1   2   3 , Rana Al Majidi  1   2   3 , Leonard Pinchuk  4   5 , Carroll A B Webers  1   2 , Henny J M Beckers  1   2 , Theo G M F Gorgels  1   2
Affiliations
Review

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

Jarno E J Wolters et al. Curr Opin Ophthalmol. .

Abstract

Purpose of review: Mitomycin C (MMC) is an alkylating agent with extraordinary ability to crosslink DNA, preventing DNA synthesis. By this virtue, MMC is an important antitumor drug. In addition, MMC has become the gold standard medication for glaucoma filtration surgery (GFS). This eye surgery creates a passage for drainage of aqueous humor (AqH) out of the eye into the sub-Tenon's space with the aim of lowering the intraocular pressure. A major cause of failure of this operation is fibrosis and scarring in the sub-Tenon's space, which will restrict AqH outflow. Intraoperative application of MMC during GFS has increased GFS success rate, presumably mainly by reducing fibrosis after GFS. However, still 10% of glaucoma surgeries fail within the first year.

Recent findings: In this review, we evaluate risks and benefits of MMC as an adjuvant for GFS. In addition, we discuss possible improvements of its use by adjusting dose and method of administration.

Summary: One way of improving GFS outcome is to prolong MMC delivery by using a drug delivery system.

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