Analysis of the Systemic Exposure of Mitomycin C Used in Glaucoma Filtering Surgery Among Women in the Reproductive Age Group

Abstract

Purpose

Systemic absorbtion of topically applied mitomycin C (MMC) during trabeculectomy needs to be evaluated to look for any systemic toxicity, which might be a major concern in certain conditions like pregnancy.

Methods

After obtaining ethical committee clearance, female patients in the reproductive age group undergoing trabeculectomy with MMC were included. Pregnant/lactating patients, patients with any systemic illness were excluded. During trabeculectomy, 0.02% MMC was applied subconjunctivally for 2 min and then washed. Blood samples were withdrawn at 1, 2, 4, 8, 12, and 24 hrs after the surgery and analyzed of MMC levels using Liquid chromatography-tandem mass spectroscopy (LC-MS/MS).

Results

The mean age of the participants was 29 ± 12 years. MMC was not detected in any of the plasma samples analyzed as it was less than the detection limit (<1.56 ng/mL) of the employed LC-MS/MS assay.

Conclusion

It can be deduced that the systemic absorption of MMC is negligible or the plasma concentration is less than 1.56 ng/ml (1000 times less than the concentration where systemic toxicity was not observed).

Keywords:

• Trabeculectomy
• mitomycin C
• pregnancy
• systemic absorption

Disclosure statement

No potential conflict of interest was reported by the author(s). The manuscript has been read and approved by all the authors. The requirements for Authorship (as advised) have been met. Each author believes that the manuscript represents honest work. Each author warrants that he/she has no commercial interest/associations that might pose a conflict of interest in connection with the submitted article.

Data availability statement

The data that support the findings of this study are available on request from the corresponding author DA