Conjunctival Fibrosis after Application of Mitomycin C: An Animal Experimental Study

Mitomycin C (MMC) is widely used as an antimetabolite to minimize scarring of filtering blebs. Its effectiveness has been demonstrated in several clinical studies. The drug's mechanism of action is attributed to its antiproliferative effect on the subconjunctival cells, reducing the wound healing response. We placed sponges soaked with various concentrations of MMC, from 0.05 to 1.0 mg/ml, under the conjunctiva of 18 rabbits. Four weeks later, there was marked concentration-dependent scarring of the substantia proppria of the conjunctiva. Macrophages were more numerous in treated eyes, as determined by immuno-histochemistry. The reason for MMC-related fibrosis in this animal model is not clear but may be related to the substances toxic effects. Whether it is only present in rabbits remains to be clarified.