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

J.E.J. Wolters; R.J.S. van Mechelen; R. Al Majidi; L. Pinchuk; C.A.B. Webers; H.J.M. Beckers; T.G.M.F. Gorgels

doi:10.1097/ICU.0000000000000729

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

J.E.J. Wolters^*, R.J.S. van Mechelen, R. Al Majidi, L. Pinchuk, C.A.B. Webers, H.J.M. Beckers, T.G.M.F. Gorgels^*

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

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

Original language	English
Pages (from-to)	148-159
Number of pages	12
Journal	Current Opinion in Ophthalmology
Volume	32
Issue number	2
DOIs	https://doi.org/10.1097/ICU.0000000000000729
Publication status	Published - 1 Mar 2021

Keywords

Drug delivery system (DDS)
GFS failure
drug delivery system (dds)
fibrosis
gfs failure
glaucoma filtration surgery (GFS)
glaucoma filtration surgery (gfs)
mitomycin C (MMC)
mitomycin c (mmc)
FIBROSIS
GEL STENT
TRABECULECTOMY BLEBS
SUSTAINED-RELEASE FORMULATION
UPPER URINARY-TRACT
AQUEOUS-HUMOR
DRAINAGE DEVICE
OPEN-ANGLE GLAUCOMA
MULTIPLEX CYTOKINE ANALYSIS
THERMOSENSITIVE POLYMER

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10.1097/ICU.0000000000000729

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

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

keywords = "Drug delivery system (DDS), GFS failure, drug delivery system (dds), fibrosis, gfs failure, glaucoma filtration surgery (GFS), glaucoma filtration surgery (gfs), mitomycin C (MMC), mitomycin c (mmc), FIBROSIS, GEL STENT, TRABECULECTOMY BLEBS, SUSTAINED-RELEASE FORMULATION, UPPER URINARY-TRACT, AQUEOUS-HUMOR, DRAINAGE DEVICE, OPEN-ANGLE GLAUCOMA, MULTIPLEX CYTOKINE ANALYSIS, THERMOSENSITIVE POLYMER",

author = "J.E.J. Wolters and {van Mechelen}, R.J.S. and {Al Majidi}, R. and L. Pinchuk and C.A.B. Webers and H.J.M. Beckers and T.G.M.F. Gorgels",

note = "Funding Information: This work was supported by the framework of the Chemelot Institute for Science and Technology (InSciTe) under Grant BM3.03 SEAMS. Publisher Copyright: {\textcopyright} 2021 Lippincott Williams and Wilkins. All rights reserved.",

year = "2021",

month = mar,

day = "1",

doi = "10.1097/ICU.0000000000000729",

language = "English",

volume = "32",

pages = "148--159",

journal = "Current Opinion in Ophthalmology",

issn = "1040-8738",

publisher = "Lippincott Williams and Wilkins Ltd.",

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TY - JOUR

T1 - History, presence, and future of mitomycin C in glaucoma filtration surgery

AU - Wolters, J.E.J.

AU - van Mechelen, R.J.S.

AU - Al Majidi, R.

AU - Pinchuk, L.

AU - Webers, C.A.B.

AU - Beckers, H.J.M.

AU - Gorgels, T.G.M.F.

N1 - Funding Information: This work was supported by the framework of the Chemelot Institute for Science and Technology (InSciTe) under Grant BM3.03 SEAMS. Publisher Copyright: © 2021 Lippincott Williams and Wilkins. All rights reserved.

PY - 2021/3/1

Y1 - 2021/3/1

N2 - 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. One way of improving GFS outcome is to prolong MMC delivery by using a drug delivery system.

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

KW - Drug delivery system (DDS)

KW - GFS failure

KW - drug delivery system (dds)

KW - fibrosis

KW - gfs failure

KW - glaucoma filtration surgery (GFS)

KW - glaucoma filtration surgery (gfs)

KW - mitomycin C (MMC)

KW - mitomycin c (mmc)

KW - FIBROSIS

KW - GEL STENT

KW - TRABECULECTOMY BLEBS

KW - SUSTAINED-RELEASE FORMULATION

KW - UPPER URINARY-TRACT

KW - AQUEOUS-HUMOR

KW - DRAINAGE DEVICE

KW - OPEN-ANGLE GLAUCOMA

KW - MULTIPLEX CYTOKINE ANALYSIS

KW - THERMOSENSITIVE POLYMER

U2 - 10.1097/ICU.0000000000000729

DO - 10.1097/ICU.0000000000000729

M3 - (Systematic) Review article

C2 - 33315724

SN - 1040-8738

VL - 32

SP - 148

EP - 159

JO - Current Opinion in Ophthalmology

JF - Current Opinion in Ophthalmology

IS - 2

ER -

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

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