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Abstract Purpose: Mitomycin C (MMC) is commonly administered during filtering surgery to enhance the success of the procedure. Unfortunately the increased success rate is associated with complications including bleb leaks, endophthalmitis, and ciliary epithelial toxicity. The purpose of this study was to investigate other regimen of MMC to reduce the incidence of these complications. Methods: Trabeculectomy was performed in 40 rabbit’s eyes. MMC was applied intraoperatively with a concentration of 0.3mg/ml in one group(n=10), postoperatively by means of sponge with a concentration of 0.05mg/ml once daily for three days in another group(n=10), and postoperative eye DROPs with a concentration of 0.02mg/ml three times daily for a week (n=10). Normal saline was administered during surgery in another control group (n=10). The time of bleb failure was determined and the eyes were evaluated histopathologically. Success and toxicity were compared for the different treatment groups. Results: the median time until trabeculectomy failure was 5 days for the control group, 13 days with administration of MMC 0.3mg/ml during surgery, 12 days with administration of MMC 0.05mg/ml by sponge topically for three days post operatively and 10 days for MMC 0.02mg/ml eye DROPs three times per day for one week postoperatively. Light microscope evaluation revealed dense collagen fibers with no edema in between in the control group, density was least for intra operative application followed by sponge application and lastly the eye DROPs application. On electron microscope examination of the ciliary body epithelium, toxic effects were greatest with intra operative application and least with eye DROPs application post operatively. Conclusion: the effect of MMC on trabeculectomy survival was maximal with intra operative application. Other methods of application were less effective but caused less toxicity. |