DR. YOGITA PUNJABI

, DR. GANESH V. RAMAN, Dr.PREM ANAND CHANDRAN, Dr.Rinu George

Abstract

Trabeculectomy is the gold standard surgical procedure for glaucoma,fibrosis of subconjuctival tissue leads to bleb failure ,decreasing long term success .Adjunctive use of antiproliferative agents like MMC improves prognosis by inhibiting fibroblast proliferation.However it has increased the incidence of bleb related complications like thin avascular bleb,hypotony,blebitis,endophthalmitis,shallowAC,Choroidal detachment depending on number&material of sponges used and area of application.Advantages of intraoperative injection MMC: Ideal bleb formation with no risk of above mentioned complications,Careful disposal of sponges not required,aerosol liberation during wash is absent-which in long run is proven less carginogenic to staff,inadvertent endothelial toxicity is not there as it is given far posterior away from limbus,loss of sponge posteriorly is unlikely.MMC is available as 2mg/4mg powder diluted with distilled water to get appropriate concentration of 0.2-0.4 mg/ml in 0.1 ml.