Histopathologic effects of mitomycin C after trabeculectomy in human glaucomatous eyes with persistent hypotony

Am J Ophthalmol. 1994 Aug 15;118(2):225-37. doi: 10.1016/s0002-9394(14)72903-4.


We evaluated the histopathologic findings in seven patients who underwent surgical revision of the filtration site after trabeculectomy with mitomycin C because of persistent hypotonous maculopathy. Light microscopic examination of subconjunctival tissue and sclera demonstrated hypocellularity of fibroblasts and disruption of the normal architecture. Tissue fragments at the margin of the bleb wall demonstrated scarring and contained multiple fibroblasts. Additionally, we investigated the histopathologic changes in an eye obtained from a patient who died one week after a trabeculectomy with mitomycin C. Transmission electron microscopy showed myelin figures, increased melanolipofuscin granules, vacuolated cytoplasm, and disrupted mitochondria of the ciliary body epithelium underlying the site of mitomycin C application. On the basis of these findings, both overfiltration because of tissue disorganization of the filtering bleb and aqueous hyposecretion because of ciliary body toxicity might be involved in the causes of persistent hypotony after mitomycin C trabeculectomy.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Ciliary Body / drug effects
  • Ciliary Body / ultrastructure
  • Combined Modality Therapy
  • Conjunctiva / drug effects
  • Conjunctiva / ultrastructure
  • Female
  • Fluorouracil / administration & dosage
  • Glaucoma / pathology*
  • Glaucoma / therapy
  • Humans
  • Male
  • Middle Aged
  • Mitomycin / pharmacology*
  • Ocular Hypotension / etiology
  • Ocular Hypotension / pathology*
  • Ocular Hypotension / therapy
  • Reoperation
  • Sclera / drug effects
  • Sclera / ultrastructure
  • Surgical Flaps / pathology
  • Suture Techniques / adverse effects
  • Trabeculectomy*


  • Mitomycin
  • Fluorouracil