The objective of
this prospective, non-randomized study of consecutive cases is to determine the
concentration of mitomycin C (MMC) in ocular tissues following intraoperative
application. A sponge soaked with 0.4mg/ml of MMC was applied for 5 minutes to
the episclera of eyes with primary glaucoma undergoing standard trabeculectomy
or combined trabeculectomy and cataract surgery. The eye was then irrigated
with 40 mls of normal saline. Tenon’s
tissue, trabeculectomy specimens and aqueous were analyzed for MMC
concentration using High Performance lLiquid Chromatography (HPLC). There were 26 eyes of 26 patients. There were equal numbers of men and
women. Their mean age was 67.4 ± 11.8 years. There were 15 eyes with primary open angle glaucoma and 11
eyes with chronic angle closure glaucoma.
The concentration of MMC in the limbal block ranged from 0 to 3.5ng/mg (
mean ± S.E, 0.8 ± 0.2ng/mg). The concentration of MMC in the Tenon’s tissue ranged from 0
to 21.5ng/mg (4.5 ± 1.08ng/mg). In conclusion, we found widely
varying concentrations of MMC in the ocular tissues even with the use of the
same surgical technique and application of MMC followed by irrigation. This may
contribute to the variation in the surgical success of MMC augmented
trabeculectomies.