CLINICAL SCENARIO A 30-year-old overseas contract worker consulted the outpatient department for a noninflamed, large, slightly vascularized, fleshy mass that encroached on the limbus of the right eye and reached the paracentral area of the cornea. The mass gradually increased in size over the past 3 years, associated with occasional redness that spontaneously resolved without any medication. The vision in the right eye degenerated over the last year. There were no other ocular or systemic signs and symptoms, and no surgery was ever done in that eye. Visual acuity was 20/40 (correctable to 20/20) in the right eye (OD) and 20/20 uncorrected in the left eye (OS). Manifest refraction revealed an against the-rule astigmatism of -2.0 diopters OD and plano OS. The rest of the ophthalmic examination was normal. His agency instructed him to have the mass removed prior to departure for Dubai in about 4 months. Since the mass was already causing astigmatism and reduced uncorrected visual acuity, surgery was contemplated. The ophthalmologist on duty wants to know whether the traditional bare-sclera technique is still the best method to use in treating this disease and preventing recurrence CLINICAL QUESTION: Pertinent data presented include a noninflamed, fleshy mass that over a period of 3 years gradually crossed the limbal border into the paracentral area of the cornea causing a two-diopter against-the-rule astigmatism. In the absence of any previous eye surgery, this picture is compatible with a primary pterygium After identifying the ocular condition in the clinical scenario, a clinical question can now be formulated as follows: Among patients with primary pterygia, how effective is bare-sclera technique compared to adjuvant treatment with mitomycin C (MMC) or conjunctival autografting (CA) in minimizing pterygium recurrence? (Author)
MITOMYCIN

Purpose: To prevent the occurrence of secondary cataract after ECCE with PC-IOL implantation and evaluate the safety and effectiveness of Mitomycin C and 5-FU when used intraocular as an irrigating solution for its prevention in rabbits Materials and Methods: 15 rabbits were divided into 3 groups: Group A was given 5-50 mg/ml FU in 500 cc of BSS plus solution; Group B received MMC 0.2 percent mg/ml in 500 cc BSS; and Group C served as control with pure BSS. The study was done in accordance with the guidelines published by ARVO. The investigated drug solution was used as irrigating solution in cataract extraction performed in rabbits. Postoperatively, the rabbits examined under slit lamp from the 1st post op day and every 3 days thereafter. Their globes were enucleated 2 wks post op and 4 weeks post op, and sent to Pathology Laboratory for processing Results: Group A and Group B showed clear posterior capsule with no evidence of epithelial cell migration. Group C showed evidence of minimal to moderate epithelial cell migration and proliferation with fibrosis Conclusion: Mitomycin C (MMC) and 5-FU minimized and even prevented secondary cataract formation, with no effect on ocular structures when used as an irrigating solution.
Animal ; MITOMYCIN ; MITOMYCIN C ; MITOMYCINS

No abstract available.
Constriction, Pathologic* ; Dilatation* ; Mitomycin*

No abstract available.
Humans ; Mitomycin* ; Trabeculectomy*

The purpose of this study was to evaluate the efficacy of conjunctival autograft with single intraoperative application of MMC 0.04% within 3 minutes in primary and recurrent pterygium and to compare this method with other’s. Sixty three patients (68 eyes: 50 eyes with primary and 18 eyes with recurrent pterygium) underwent pterygium excision with conjunctival autograft and single application of MMC 0.045/3 minutes. Patients were followed from 3 to 12 months after operation. Results: recurent rate of 1.96% (1 eye) was observed in the group of recurrent pterygium. There were 2 cases of superficial punctuate keratitis. Conclusion: this study indicates that intraoperative administration of a single dose of 0.04% MMC with conjunctival autograf is an effective treatment for prevention of recurrence of pterygium
Pterygium ; Transplantation, Autologous ; Mitomycin

The purpose of this study is to compare the effects of three different concentrations of mitomycin-C(MMC) as an adjunct therapy to trabeculectomy. We reviewed 26 patients(36 eyes) who underwent trabeculectomy in which MMC was applied intraoperatively. The application time was 5 minute, and concentration of MMC was 0.1mg/ml(n=10), 0.2mg/ml(n=17) and 0.41mg/ml(n=9) respectively. The mean IOP at postoperative 3 months was significantly lower in 0.4mg/ml group (10.4 +/- 5.5mmHg) than in the 0.2mg/ml group(16.1 +/- 4.7mmHg)(p<0.05). There was no statistical difference among the three groups in the success rate regardless of medication, the size and longevity of bleb. The postoperative hypotony(2 eyes) was noted in the 0.4mg/ml group. In conclusions, It is desirable to use the lowest concentration of MMC that will facilitate bleb formation.
Blister ; Longevity ; Mitomycin* ; Trabeculectomy*

No abstract available.
Animals ; Caffeine* ; Mice* ; Mitomycin*

Objective: To determine the effect of topically administered bevacizumab on bleb survival and histology after trabeculectomy in rabbit eyes. Methods: This is an experimental interventional comparative animal study. Sixteen rabbit eyes underwent trabeculectomy, 8 of which were enhanced with intraoperative mitomycin-C. Eyes were randomized to receive either topical balanced salt solution (BSS) or topical bevacizumab at a concentration of 12.5 mg/mL. Intraocular pressure, bleb dimensions and vascularity grading were measured. IOP was recorded as a ratio of IOP of the experimental operated eye divided by the IOP of the contralateral control eye (IOPratio) as a function of time. Bleb morphology was recorded as a percentage of the maximum estimated bleb volume (% bleb) as a function of time. Bleb failure occurred if IOPratio ≥0.8, or if % bleb=0. The eyes were then submitted for histopathological analysis after bleb failure has occurred. Results: In plain trabeculectomy, the mean bleb survival in terms of IOP were 6.3 and 9.2 days in the BSS and topical bevacizumab groups respectively (ρ=0.25). In mitomycin-C-enhanced trabeculectomy, the mean bleb survival was 16 and 18.2 days respectively (ρ=0.40). In plain trabeculectomy, mean bleb survival in terms of bleb morphology were 8 and 12.2 days for the BSS and bevacizumab groups respectively (ρ=0.08). In enhanced trabeculectomy, mean bleb survival were 19.5 and 20 days respectively (ρ=0.99). Mean vascularity grading were 2 and 1.9 for the BSS groups, and 1.6 and 1.4 for the bevacizumab groups. Conclusion Topical bevacizumab as adjunctive therapy after trabeculectomy, whether plain or enhanced with mitomycin-C, showed a trend towards prolonged bleb survival, even though the results of this study were not statistically significant.
Bevacizumab ; Trabeculectomy ; Mitomycin

Viscoelastic substance or Mitomycin C(MMC)is not necessarily used in trabeculectomy. Hence, the authors investigated the rate of cataract development or progression after trabeculectomy related with using of the viscoelastic substance or MMC. The authors evaluated 119 eyes undergoing trabeculectomy and divided these eyes into 4 groups :group 1, 2, 3, and 4. In group 1, viscoelastic substance or MMC was not used(27 eyes). In group 2, only viscoelastic substance was used(35 eyes). In group 3, only MMC was used(15 eyes). In group 4, both viscoelastic substance and MMC were used(42 eyes). The cataract development or progression was examined with slit-lamp biomicroscope at postoperative 6 months and defined as the decrease of visual acuity more than 2 lines. The rate of cataract development or progression at postoperative 6 months was 18%in group 1, 14%in group 2, 40%in group 3, and 19%in group 4.The use of MMC without viscoelastic substance in trabeculectomy influenced cataract development or progression extremely. In conclusion, the results of this study suggest that the viscoelastic substance may reduce the rate of cataract development or progression after trabeculectomy in which MMC is used besides.
Cataract* ; Mitomycin* ; Trabeculectomy* ; Visual Acuity

The authors evaluated the efficacy of intraoperative application of mitomycin C 0.4 mg/1 ml x 3 minutes in primary pterygium excision and compared this method with other’s. 166 patients (170 eyes) with primary pterygium were asigned randomly to 3 groups: group 1 received pterygium excision with intraoperative application of 0.4 mg/1 ml mitomycin C for 3 minutes (58 eyes: 14 eyes with pterygium. II degree, 44 with pterygium III-IV degree); group 2 received conjunctival autograf (56 eyes; 12 with pterygium II degree, 44 with pterrygium III-IV degree). Patients were followed 1,3,6 and >12 months after operation. Results: after a folow-up time there were not recurrences in patients of group 1 and 2; recurrences developed only in 15 (26.77%) of 56 eyes in group 3. There were not complications in and after operation. Conclusion: this study indicates that intraoperative application of mitomycin C in primary pterygium excision is an effective treatment for prevention of recurrence of pterygium.
Pterygium ; Intraoperative Care ; Mitomycin ; therapeutics