Preoperative mitomycin-C subconjunctival injection and glaucoma filtering surgery.
Intraoperative mitomycin-C application has been well accepted recently as a useful adjunctive procedure to enhance the filtering effect in glaucoma surgery. However, the exact dose of mitomycin-C left after such a procedure in the ocular tissue is variable and unclear. It is important to determine such residual because of potential long-term toxicity of mitomycin-C to the eye. Based on previous successful experience using preoperative mitomycin-C subconjunctival injection in the THC-YAG laser sclerostomy on rabbits, the effect of intraocular pressure (IOP) control and its clinical observation was studied in six eyes of six refractory and high risk glaucoma patients by subconjunctival 1.2 micrograms to 3.6 micrograms mitomycin-C injection 24 to 72 hours prior to classic, routine, limbal-based trabeculectomy surgery. After 18 months of satisfactory clinical observation of the first eye for IOP, functioning bleb appearance and smooth clinical course, the same procedure was used on an additional five eyes, with a follow-up period of more than five months. Average IOP was reduced from 27.8 mm Hg (range 24 to 34 mm Hg) preoperatively to 9.5 mm Hg (range 5 to 14 mm Hg) postoperatively, with a smooth clinical course. The advantages of such preoperative subconjunctival mitomycin-C injection are emphasized here.
Hung
P T
PT
Department of Ophthalmology, National Taiwan University, Taipei, Republic of China.
Lin
L L
LL
Hsieh
J W
JW
Wang
T H
TH
D000293:Adolescent; D000328:Adult; D000818:Animals; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002648:Child; D003228:Conjunctiva; D005260:Female; D005901:Glaucoma / Q000628:therapy*; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D010865:Pilot Projects; D011292:Premedication; D011817:Rabbits; D014130:Trabeculectomy; D014792:Visual Acuity; D014794:Visual Fields
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin