Decrease of intraocular pressure after subconjunctival injection of mitomycin in human glaucoma
S. A. Gandolfi, M. Vecchi and L. Braccio
Ambulatorio Glaucoma, Istituto di Oftalmologia, Universita' di Parma, Italy.
OBJECTIVE: To investigate the effects of a subconjunctival injection of
mitomycin on the intraocular pressure in human eyes affected by glaucoma.
DESIGN: Consecutive case series, prospective study, intraocular pairwise
comparison (paired samples Student's t test adopted). SETTING:
Hospital-based glaucoma clinic. PATIENTS: Twelve consecutive patients with
bilateral glaucoma and monolateral blindness, intraocular pressure greater
than 30 mm Hg in the blind eye (mean of the two highest values of the
diurnal curve, confirmed at 96-hour interval), and no previous bulbar
surgery. INTERVENTION: Subconjunctival injection of 0.5 mL of 0.2%
mitomycin in the upper temporal quadrant, preceded and followed by
treatment with topical indomethacin. MAIN OUTCOME MEASURE: Analysis of the
variance of the mean intraocular pressure before and after the injection of
mitomycin in each eligible eye. RESULTS: An intraocular pressure decrease
was observed in each eligible eye the day after the treatment (mean [+/-
SD] decrease, 7.15 +/- 1.46 mm Hg). The effect was still detectable at the
end of the 60 days of follow-up (mean [+/- SD] decrease, 5.67 +/- 1.61 mm
Hg). No change of intraocular pressure, in the meantime, was observed in
the fellow eye. CONCLUSIONS: Topically applied mitomycin induces a decrease
of intraocular pressure in human glaucomatous eyes. Our data confirm
previous results obtained in albino rabbits and support the hypothesis that
mitomycin exerts a still unknown direct effect on aqueous humor dynamics in
the eye.
