Mitomycin C is applied intraoperatively during trabeculectomy to improve surgical success. Its beneficial effect on bleb survival results from:
- A Stimulation of aqueous humor production by the ciliary epithelium
- B Irreversible inhibition of fibroblast proliferation in the episcleral tissue ✓
- C Relaxation of the trabecular meshwork cytoskeleton
- D Suppression of vascular endothelial growth factor in the conjunctiva
Correct answer: B. Irreversible inhibition of fibroblast proliferation in the episcleral tissue
Explanation
Trabeculectomy fails mainly because subconjunctival and episcleral fibroblasts proliferate and lay down collagen, scarring the filtration bleb shut. Mitomycin C is an alkylating agent that irreversibly inhibits DNA synthesis and cell division, so a single intraoperative application suppresses fibroblast proliferation and prolongs bleb function. It has no action on aqueous secretion, meshwork tone, or VEGF signaling.
Reference: Parsons' Diseases of the Eye, 23rd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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