Effect of Mitomycin C on Glaucoma Filtering Surgery.

Jung, Hai Ryun; Huh, Kuhl

Original Article

Journal of the Korean Ophthalmological Society 1986;27(6):1129-1138.
Published online June 1, 1986.

Effect of Mitomycin C on Glaucoma Filtering Surgery.

Hai Ryun Jung, Kuhl Huh

Department of Ophthalmology, Korea University, College of Medicine, Seoul, Korea.

녹내장 여과수술후 Mitomycin C 의 효과

허걸(Geol Huh),정해륜(Hae Ryun Chung)

Abstract

The purpose of glaucoma filtering surgery is to maintain low intraocular pressure byoontinuous filtration of aqueous humor. Filtration failure commonly results from scarring at the surgical site. Fibroblast plays an important role in the scarring process. Mitomycin C and 5-fluorouracil are the antimetabolites capable of inhibiting fibroblast proliferation. In this animal experiment, the authors studied electron microscopically the effect of Mitomycin C and 5-fluorouracil on the fibroblast proliferation at the surgical site. Posterior sclerectomy was performed to 9 eyes of 9 normal rabbits. Postoperatively, 3 eyes recieved subconjunctival injection of Mitomycin C, 3 eyes 5-fluorouracil and 3 eyes normal saline as a control. Additional one eye of a rabbit was used for observation of normol fibroblast. Animals were killed two days, four days, six days following surgery at the time of 12 hours after the last injection. Globes were immediately removed and processed for transmission electron microscopic examination. The results were as follows; 1. Normal fibroblasts in episclera showed dilated cisternae of rough endoplasmic reticulum (RER). 2. Two days after operation, the fibroblasts were slightly activated. 3. Four days after operation, cytoplasmic organelles in fibroblasts were more activated. 4. Six days after operation, secreting forms of fibroblast were visible. The fibrillar materials of moderate electron density pooled in cisternae of RER, and the filamentous elements were in the periphery of the cytoplasm. 5. In Mitomycin C treated group, there was no remarkable change in the cytoplasmic organelles, but some dilation of RER was noted four days after operation. 6. In 5-fluorouracil treated group, there was the same feature as in Mitomycin C group, but milder. 7. Conclusively, Mitomycin C and 5-fluorouracil are considered effective on the inhibition of fibrogenesis with lowering of fibroblastic activity.