LONG-TERM EFFECTS OF MITOMYCIN ON FILTERING BLEBS - LACK OF FIBROVASCULAR PROLIFERATIVE RESPONSE FOLLOWING SEVERE INFLAMMATION

Background and Objective.-The use of antimetabolites, such as fluorour acil and mitomycin, enhances the success rate of filtering surgery, es pecially in eyes at high risk for failure, and increases the likelihoo d of a thin, avascular filtering bleb. In addition, mitomycin may caus e long-term inhibition of the fibroblast's ability to proliferate in t he conjunctiva and Tenon's capsule. Preoperative and postoperative inf lammation frequently contributes to scarring of filtering blebs. The p urpose of this study is to evaluate the effect of intraoperative mitom ycin use on the survival of filtering blebs after severe inflammation. Design.-We retrospectively studied three eyes that had undergone trab eculectomy with intraoperative mitomycin. Two eyes had concomitant int raocular lens implantation. All three eyes had blebs that functioned w ell postoperatively. Patients.-These eyes sustained episodes of intens e inflammation in the form of herpes zoster ophthalmicus, endophthalmi tis, or purulent infection of the bleb postoperatively. Results.-Follo wing treatment of the inflammation, no change in the appearance or fun ction of the bleb could be detected. Conclusion.-Either the indirect e ffect of mitomycin in producing a thin, avascular bleb or a long-term effect of mitomycin on the ability of conjunctival and Tenon's capsule fibroblasts to proliferate may have contributed to bleb survival.