DECREASE OF INTRAOCULAR-PRESSURE AFTER SUBCONJUNCTIVAL INJECTION OF MITOMYCIN IN HUMAN GLAUCOMA

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.