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 languageEnglish
Pages (from-to)148-159
Number of pages12
JournalCurrent Opinion in Ophthalmology
Volume32
Issue number2
DOIs
Publication statusPublished - 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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