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Postoperative Bleb Management with Topical Mitomycin-C

Ophthalmic Research Center
Publication Date
  • Editorial
  • Medicine


77 Editorial JOURNAL OF OPHTHALMIC AND VISION RESEARCH 2011; Vol. 6, No. 2 Postoperative Bleb Management with Topical Mitomycin‑C Jost B Jonas, MD Department of Ophthalmology, Mannheim Medical Faculty of the Ruprecht-Karls-University, Heidelberg, Germany Despite various developments in many fields of ophthalmology, the surgical therapy of open-angle glaucoma has remained mostly unchanged over the last 30 years. Ever since the introduction of intraoperative mitomycin and postoperative subconjunctival injections of 5-fluorouracil (5-FU), trabeculectomy has not markedly been altered. These facts stand in contrast to the need for a more efficient surgical therapy for open-angle glaucoma, since one of the main disadvantages of filtering surgery is the lack of enduring success. Large- scale retrospective studies have suggested that filtering blebs become non-functional in at least 50% of patients, 5 years after surgery. This clearly demonstrates the necessity for developing techniques to reduce postoperative scarring in filtering blebs. I n t h e c u r r e n t i s s u e o f J o u r n a l o f Ophthalmic and Vision Research, Pakravan and colleagues1 have examined the effect of postoperative topical mitomycin 0.02% eye drops on the success of trabeculectomy surgery and compared the results with that of repeated postoperative subconjunctival 5-FU injections. In their randomized study, for which the authors have to be commended, the authors found that topical mitomycin compared favorably with subconjunctival 5-FU injections. Since eye drops are easier to apply and cause less pain, topical application of mitomycin appears to be a valid alternative to subconjunctival 5-FU injections in the postoperative period. Certain questions however remain. First, interestingly, the toxicity of mitomycin applied topically on intact conjunctival epithelium is considerably less than that applied on bare sclera. Future studies may address whether this disparity i

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