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KMID : 0350519940470020913
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Journal of Catholic Medical College
1994 Volume.47 No. 2 p.913 ~ p.927
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The Efficacy of Mitomycin-C on Glaucoma Filtration Surgery in Rabbits
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Abstract
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To investigate the usefulness of subconjunctivally injected mitomycin- C(MMC) as a adjunctive therapy following the glaucoma filtration surgery(GFS), various amounts of MMC have been given to rabbit eyes after the surgery. One hundred and twenty
rabbits
were all subjected to the GFS and then divided into 4 groups(30 rabbits in each group). To the control group, balanced salt solution (BSS) was injected subconjunctivally and 0.05mg MMC dissolved in BSS was given to the experimental group I, 0.1mg
to the
group Ⅱ, and 0.2mg to the group Ⅲ. Subsequently, the effect of MMC on intraocular pressure(IOP) and the outcome of the slit-lamp biomicroscopy results were followed for 12 weeks. Also, at 2 and 12 weeks following the GFS and administration of
MMC, the
degree of inhibiting the fibroblast infiltration and also the degree of fibrosis at the filtering site have been examined by light microscopy. Furthermore, at 30 minutes after the administration of MMC, samples of the aqueous humor and the cornea
were
taken and the concentration of MMC in these samples were measured by employing a high performance liquid chromatography(HPLC). Also, by employing a scanning electron microscope, the finer structural alterations in corneal endothelium was examined
on the
3 day following the GFS and administration of MMC.
@ES Following results have been observed:
@EN 1 In the control BSS group, the IOP was returned to preoperative level at postoperative 2 weeks. The IOP of the 0.05mg MMC treated group(I) and the 0.1mg MMC treated group(Ⅱ)were returned to the preoperative leval by 12 weeks after the GFS.
However, the IOP in group Ⅲ(0.2 mg MMC) remained below the preoperative level for 12 weeks.
2. There were some complications by the MMC injection given after the CFS. While there was a minor corneal epithelial erosion(3.3%) in group I, as the MMC concentration was increased, there were more complications. Thus, for group Ⅱ, there were
corneal epithelial erosion(6.7%), corneal hazes(6.7%) and bleb perforations(3.3%). For the group Ⅲ, there were increased MMC toxicities and showed corneal epithelial erosions(13.3%), corneal hazes(16.7%), bleb perforations(10%) and
symblepharons(10%).
3. Histological examinations conducted 2 weeks after the GFS and injection of MMC showed infiltration of lymphocytes as well as proliferations of fibroblasts, collagen fibers and reticulin fibers.
The degree of these histological aberrations decreased in the order of group Ⅲ, group Ⅱ, group I and control group. When the histological examination was carried out at 12 weeks after the GFS, while the intensity of fibroblast infilatration
increased
for group I and Ⅱ, the intensity of collagen and reticulin fiber proliferations decreased for the group I and Ⅱ. For the group Ⅲ, however, least amounsts of fibroblast infiltration and collagen and reticulin fiber proliferations were observed.
4. When the concentrations of MMC were measured in corneal tissue samples and in aqueous humor, while none was found in aqueous humor, 1.2±0.5μg of MMC/g of corneal tissue was found for group Ⅲ0.3±0.1μg/g was found for group Ⅱ. No MMC
could
be
detected in corneal tissues of group I.
5. Scanning electron microscopy results revealed that while there were no significant changes in the BSS control and in the group I tissues, some destruction of corneal endothelium was observed for group Ⅱand severe destructive changes in
corneal
endothelium was observed for group Ⅲ.
Based on these observations, subconjunctival injection of low dose(0.05mg) of MMC may be useful as an adjunctive method to enhance the success rate of GFS. However, additional experiments are meeded to reduce to the long term risk of adverse
complications caused by the MMC injection.
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KEYWORD
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