A novel method for controlling the quantity of mitomycin-C applied during filtering surgery for glaucoma.
The use of a sponge impregnated with mitomycin-C is an increasingly common practice in glaucoma surgery. The appropriate antibiotic concentration and exposure time have been considered in the literature, but not the exact amount to be used or the size of the sponge. The purpose of this study was to estimate the quantity of mitomycin-C contained in sponges prepared by different surgeons as compared to that in applicators of the type used in Schirmer's test graduation (5 x 5 mm). Four surgeons each cut and prepared 10 sponges for intraoperative use according to their usual method. The same procedure was performed with 10 Schirmer's test graduations. Each sponge and each graduation was immersed in a solution of mitomycin-C 0.2 mg/ml, and the quantity of antibiotic (microg) in each was calculated as the difference between wet and dry weight. The mean quantity (+/- SEM) of mitomycin-C contained in cut sponges was 9.6 +/- 4.4 microg (range 1.9-17.3), and the differences between surgeons were statistically significant (p<0.0001). The mean quantity of antibiotic in Schirmer's test graduation was 1.7 +/- 0.3 microg (range 1.1-2.5), and the differences between surgeons were not statistically significant (p=0.79). The quantities of mitomycin-C contained in sponges prepared for glaucoma surgery differed for a given surgeon and between surgeons. Thus, variations in the doses applied to the sclera could account for certain complications due to mitomycin-C. The use of a Schirmer's test graduation improves predictability for the quantity of mitomycin-C applied to the sclera.
Mehel
E
E
Department of Ophthalmology, Centre Hospitalo-Universitaire de Nantes, France.
Weber
M
M
Stork
L
L
Péchereau
A
A
D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D018463:Filtering Surgery; D005901:Glaucoma / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D016685:Mitomycin / Q000008:administration & dosage*; D015503:Surgical Sponges / Q000592:standards
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin