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Surgical treatment of glaucoma is usually reserved for serious cases which cannot be controlled by other means such as topical medication or laser. Surgery can be performed in most types of glaucoma in order to reduce the pressure inside the eye which if left uncontrolled can irreversibly damage the optic nerve leading to loss of sight. There are a number of variants of drainage surgery but the most commonly performed procedure is trabeculectomy in which a guarded channel is fashioned through the wall of the eye under the upper lid and the fluid is allowed to collect under the conjunctiva (the membrane lining the eyeball) to form a drainage bleb. Scarring during the healing process can cause this channel to close and the operation to fail with a rise in pressure. Mitomycin C is a powerful agent which prevents scarring by inhibiting the multiplication of cells which produce scar tissue. This review asks whether there is evidence that its use during the initial stages of surgery to prevent the excessive conjunctival scarring reduces the risk of failure of the operation. Three types of patient were included: those at high risk of failure because of previous failed surgery or other complications, those having combined cataract and glaucoma surgery and those having primary trabeculectomy ‐ an operation for the first time for their glaucoma. The review found evidence that Mitomycin C reduces the risk of surgical failure in both high risk and primary surgery but no evidence on combined cataract and glaucoma surgery. But the risk of adverse effects including an increased risk of cataracts (not in the combined group) was also noted. There were only a few studies on each category of patients and most were of only poor or moderate quality.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Raised intraocular pressure is a risk factor for glaucoma. One treatment option is glaucoma drainage surgery (trabeculectomy) to help lower intraocular pressure. Antimetabolites are medicines used during surgery to help reduce scarring after surgery during wound healing. If scarring occurs it can lead to treatment failure because the drainage channel no longer works. Two agents in common use are MMC and 5‐FU.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Bibliographic details: Li Y, Cheng SM, Zhou X, Zhou S, Xu L.  Comparison of endoscopic dacryocystorhinostomy with mitomycin c versus without mitomycin c for nasolacrimal obstruction: a meta-analysis. Chinese Journal of Evidence-Based Medicine 2013; 13(12): 1475-1481

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Bibliographic details: Zhou L, Li T, Li JZ, Song XS, Dan HD, Wu QS.  [Meta-analysis of clinical effectiveness of the treatment of limbal autograft stem cells transplantation with the use of mitomycin-C for pterygium]. International Eye Science 2013; 13(7): 1424-1427 Available from: http://www.ies.net.cn/gjykcn/ch/reader/view_abstract.aspx?file_no=201307037

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Bibliographic details: Shen Y, Gao LD, Cheng JW, Cai JP, Li Y, Wei RL.  Intra-operative mitomycin C for nonpenetrating filtering surgery in treatment of open angle glaucoma: a systematic review and meta-analysis. Academic Journal of Second Military Medical University 2012; 33(9): 1006-1011 Available from: http://www.ajsmmu.cn/ajsmmuen/ch/reader/view_abstract.aspx?file_no=20120230&flag=1

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

AIM: To evaluate the recurrence rate and safety of amniotic membrane transplantation (AMT) augmented with mitomycin C (MMC) compared with amniotic membrane transplantation alone during the pterygium excision.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

PURPOSE: To evaluate the current clinical evidence of safety and efficacy of intraoperative topical application of 0.02% mitomycin C (MMC) used for up to 2 minutes after surface ablation for correction of myopia.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

This review compared the effects of different surgeries for primary congenital glaucoma (PCG).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

When bladder cancer is confined to the lining of the bladder it is treated surgically to remove the tumours. However, the tumours may recur and so another type of treatment is often used following surgery called intravesical therapy, whereby agents are instilled directly into the bladder to prevent tumour recurrence. These agents, such as Bacillus Calmette‐Guérin (BCG) may stimulate the body’s immune system to kill any residual cancer cells, or they may be anticancer drugs that act directly on the tumour cells. A relatively new drug used in this situation is gemcitabine. We searched the published literature for randomised clinical trials that evaluated intravesical gemcitabine in bladder cancer patients and found six trials. The first trial compared a single dose of gemcitabine with a placebo immediately following surgery and found no difference in the rate of tumour recurrence, although there was some concern over the trial methodology. Another study compared gemcitabine with the established anticancer drug mitomycin C and showed that gemcitabine was more active and less toxic. Three trials compared gemcitabine with intravesical BCG. The first enrolled patients with intermediate risk of recurrence and reported gemcitabine was as effective as BCG in preventing tumour recurrence and disease progression but with fewer side‐effects. The second trial enrolled untreated patients with a high risk of recurrence and found gemcitabine to be inferior to BCG in preventing recurrence but again was less toxic than BCG. The third trial recruited patients who had previously received BCG but had not responded and this study showed that gemcitabine was superior to BCG in reducing the rate of tumour recurrence. These small numbers of trials indicate that intravesical gemcitabine has activity in delaying tumour recurrence and may have a role in patients who are not suitable for, or who have failed, BCG therapy. The final study suggested that multiple doses of gemcitabine gave better tumour responses compared to a single dose, although the clinical significance of this is unclear.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Women with cervical cancer that is too big to be removed by surgery, or has spread to the tissues around the cervix (often called locally advanced cervical cancer) may be treated with radiotherapy (treatment with x‐rays). They might also get chemotherapy (drug treatment) alongside radiotherapy. This is called chemoradiotherapy (or chemoradiation). This review brought together 18 randomised controlled trials (RCTs) that were carried out in many countries. The results of the review showed that women who had chemoradiotherapy for cervical cancer were likely to live for longer than women who had just radiotherapy. Five years after being treated, 66 out of every 100 women who received chemoradiotherapy were still alive compared with 60 out of every 100 who just had radiotherapy. Women who received chemoradiotherapy were also less likely to have the cancer come back or spread to other parts of the body. Chemoradiotherapy helped all women, even those with bigger tumours, or tumours that had spread more. Also, the different drugs that had been used in the trials (cisplatin, 5‐fluourouracil or mitomycin‐C) all helped women to live longer or stop the cancer from coming back or spreading.  Some of the short term side effects were worse for women who received chemoradiotherapy. Doctors can usually help women to cope with the short term side effects of their treatment. Unfortunately, there was not enough information to be certain whether the long‐term side effects are worse with chemoradiotherapy or not.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Standard treatment for locally advanced stage cervical cancer (stage IIB to IVA) is 'concurrent chemoradiation' when anticancer drugs are given during the same treatment period as pelvic radiotherapy (radiation therapy to lower abdomen). However, the tumour may remain (residual cancer) or may come back (recurrent cancer) after this standard treatment. This review evaluated whether giving additional anticancer drugs (ACTs) after standard treatment could help women with locally advanced cervical cancer to live longer compared with standard treatment alone.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Anti‐vascular endothelial growth factor (VEGF) agents versus control or mitomycin C (MMC) for the outcome of trabeculectomy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

OBJECTIVE: Systematically review and critically evaluate all available published data on the use of topical mitomycin C (MMC) as an adjunctive in airway surgery.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

PURPOSE: To examine the possible benefit of intraoperative use of mitomycin C (MMC) application in dacryocystorhinostomy (DCR) and to assess its potential risk.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

PURPOSE: To determine whether application of the anti-proliferation agent, mitomycin C (MMC), to the osteotomy site during dacryocystorhinostomy (DCR) surgery increases surgical success rates.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

We reviewed the evidence for the effectiveness and complications of different approaches (fornix‐based versus limbal‐based incisions) of drainage surgery (trabeculectomy) in adults with glaucoma.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

BACKGROUND: The recurrence of pterygium after surgery is high. A variety of adjunctive treatment approaches have been developed to improve the clinical efficacy and many related articles have been published. This study aimed to determine the risk for postoperative pterygium recurrence comparing autologous conjunctival transplantation (ACT) versus mitomycin C (MMC).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

PURPOSE:: To assess the efficacy and safety of trabeculectomy with Ologen implant versus trabeculectomy with mitomycin C (MMC) for treatment of glaucoma.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

BACKGROUND: A number of published comparative studies have been conducted to evaluate the efficacy and safety of intraoperative mitomycin C (MMC) in endoscopic dacryocystorhinostomy (EN-DCR). However, results have not always been consistent. Therefore, we carried out a meta-analysis to compare the clinical results of EN-DCR with and without MMC.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

OBJECTIVE: To assess the efficacy and safety of local application of intraoperative mitomycin C (MMC) at the osteotomy site in primary external dacryocystorhinostomy (EX-DCR).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

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