4 · Mechanical, surgical adjuncts & fibrosis modulators
Mitomycin C (MMC) — anti-fibrotic modulator
Review — modulators of corneal healing › 4 · Mechanical, surgical adjuncts & fibrosis modulators › Mitomycin C (MMC) — anti-fibrotic modulator
Mitomycin C (MMC) — anti-fibrotic modulator
Antineoplastic alkylating agent, intraoperative application 0.02% (0.2 mg/mL)
Oxford I–II
Strong (anti-haze)
Present · refractive
Mechanism of actionDNA cross-linking → inhibition of proliferation and apoptosis of activated keratocytes/myofibroblasts in the anterior stroma → prevention of sub-epithelial fibrosis (haze) and fibrovascular regrowth of pterygium. Does not accelerate epithelial healing (may transiently delay it); endothelial toxicity if exposure is excessive.
IndicationsProphylaxis of haze after surface photoablation (PRK/PTK), especially high myopia/retreatments; adjunct to pterygium excision (↓recurrence); glaucoma filtering surgery.
Route & dosageSingle intraoperative application to the stromal bed via sponge — 0.02% for 12 s–2 min (titrated to depth), followed by copious irrigation (BSS). No chronic topical use.
Level of evidenceOxford I–II (RCTs, dose-response) · Scale: Strong (haze prevention, pterygium recurrence).
| FDA | Approved as an antineoplastic agent; ophthalmic surgical use is off-label but standard (Mitosol 0.2 mg kit approved for glaucoma surgery). |
|---|---|
| EU MA | Hospital/compounded ophthalmic use. |
| France / USA / Asia | Available (prepared intraoperatively). |
Key studies: MMC ↓haze/apoptosis after PRK (2005) — PMID 15691552 ; dose-response RCT of MMC for anti-haze in high myopia — PMID 23830559 ; EyeWiki “MMC for Haze Prophylaxis.”