A Modified Technique in Applying Sponge Soaked with Mitomycin C in Trabeculectomy

Trabeculectomy with adjunctive use of Mitomycin C (MMC) has been a benchmark for glaucoma filtration surgery for decades. However, there are many variations in the ways that the sponges soaked with MMC are applied during the trabeculectomy surgery. We herein describe our way of placing the MMC-soaked sponges to improve the safety and efficacy of the trabeculectomy. The sponges are placed vertically and posteriorly with the long side of the sponge perpendicular to the limbus, not parallel. This will reduce the size of the conjunctival wound at the limbus to preserve more virgin conjunctiva that can be used for repeated trabeculectomy when needed. This will also facilitate a more posteriorly directed flow of aqueous drainage that, in turn, may increase the success rate of the trabeculectomy. We have obtained encouraging results in our practice, and further large-scale randomized studies seem warranted.

Automated summary

Trabeculectomy with the use of Mitomycin C (MMC) is a well-established technique for glaucoma filtration surgery, but the specific method of application of MMC-soaked sponges can vary. This study proposes a new technique of sponge placement to improve outcomes and preserve conjunctiva for future procedures, showing promising results that warrant further large-scale studies.