What is Mitomycin C?
Mitomycin C is an aziridine-containing product derived from Streptomyces caesystosus or Streptomyces lavendulae bacteria. Mitomycin C is used as a chemotherapeutic agent due to its anti-tumor antibiotic effect. It has other uses in eye care due to its ability to decrease scarring during the healing process after eye surgery.
The production of Mitomycin C is accomplished by the combination of 3-amino-5-hydroxybenzoic acid, carbamoyl phosphate, and D-glucosamine which forms a mitosane core. The 3-amino-5-hydroxybenzoic acid is also used in the development of other anti-cancer agents such as ansamycin and rifamycin.
Different Ocular Uses for Mitomycin C
Pterygium Surgery with Mitomycin C
A pterygium is an abnormal growth of tissue where the conjunctiva begins to grow from the sclera (white portion of the eye) onto the cornea. This occurs more often in people who are outdoors much of their life and live in a climate with increased sun exposure. If the pterygium grows into the area of the pupil or visual axis, it will scar the cornea in that area leading to decreased or loss of vision.
The pterygium is removed and if nothing else is done, the pterygium very commonly grows back. Applying Mitomycin C to the area of the surgery greatly decreases the chance of reoccurrence. Many eye surgeons use this as their primary method of performing pterygium surgery.
Glaucoma Surgery Using Mitomycin C
What is Glaucoma?
Glaucoma is a multi-factorial disease in which the optic nerve is damaged. This leads to a permanent loss of vision. This is mostly related to the level of the intraocular eye pressure. If the intraocular pressure cannot be controlled with medication or laser treatment, then a glaucoma surgical procedure is performed.
An opening is made in the eye to let fluid filter out of the eye into an area underneath the conjunctiva (the tissue covering over the white portion of the eye containing the blood vessels visible on the surface of the eye). Many times the body with its healing process will close off the opening the filtration surgery. Mitomycin C is used by many eye surgeons to decrease the body’s ability to scar the glaucoma filtration surgery closed.
Refractive Surgery with Mitomycin C
Many years after radial keratotomy has been performed, some people develop scarring around the incisions that were made with the radial keratotomy surgery. If this scarring occurs near the pupil, it can cause blurred or loss of vision. The scarred corneal tissue can be removed and Mitomycin C is used to decrease any new scarring.
LASEK performed in young people who have significant myopia have a higher risk of developing corneal haze or scarring of the cornea after the surgery. Mitomycin C is applied to the cornea during the operation which diminishes the risk of scarring and loss of vision.
Mitomycin C has had a significant benefit in its use in treatment for certain ocular diseases and conditions. It prevents scarring secondary to the healing response related to ocular surgeries which can cause a failure of the surgical procedure.