[Effect of mitomycin C on aqueous humor flow after trabeculectomy].
The intraoperative application of the antimetabolite mitomycin C has been recommended extensively in the literature for trabeculectomy in eyes with poor prognosis glaucoma. The modulation of wound healing with the antimetabolite mitomycin C has increased the success and predictability of filtration surgery. However, eyes in which mitomycin C is applied topically via a sponge during surgery bear the risk of developing postoperative hypotony and a decrease in visual acuity. Anterior chamber fluorophotometry (Fluorotron Master II, Coherent, Palo Alton) was used to study the effect of trabeculectomy with and without mitomycin C on the aqueous humour dynamics in glaucomatous eyes 6 months postoperatively. A 0.5-mg/ml solution of mitomycin C was applied topically via a sponge under the conjunctival flap. In a second group the same type of limbus-based flap was performed without the use of mitomycin C. The subsequent procedure was identical in both groups. Six months after surgery the eyes without mitomycin C revealed normal aqueous humour flow during the afternoon hours, comparable with the unoperated fellow eyes (mean 2.1 microliters/min). Eleven eyes treated with mitomycin C showed a reduction of aqueous humour flow of about 56% (mean 0.9 microliter/min) when compared with the unoperated contralateral eye and an age-, race- and sex-matched group. The fluorophotometric data suggest that the significant reduction of aqueous humour flow is the reason for the hypotony seen in glaucomatous human eyes following trabeculectomy with mitomycin C.
Diestelhorst
M
M
Universitäts-Augenklinik Köln.
Krieglstein
G K
GK
D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects; D001082:Aqueous Humor / Q000187:drug effects*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage* / Q000009:adverse effects; D009883:Ophthalmic Solutions; D014130:Trabeculectomy; D014792:Visual Acuity / Q000187:drug effects
D000903:Antibiotics, Antineoplastic; D009883:Ophthalmic Solutions; D016685:Mitomycin