GLAUCOMA: Edited by Donald L. BudenzHistory, presence, and future of mitomycin C in glaucoma filtration surgeryWolters, Jarno E.J.a,b,c; van Mechelen, Ralph J.S.a,b,c; Al Majidi, Ranaa,b,c; Pinchuk, Leonardd,e; Webers, Carroll A.B.a,b; Beckers, Henny J.M.a,b; Gorgels, Theo G.M.F.a,b Author Information aUniversity Eye Clinic Maastricht, Maastricht University Medical Centre + (MUMC+), Maastricht bChemelot Institute for Science and Technology (InSciTe), Geleen cSchool for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands dInnFocus, Inc., a Santen Company eOphthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA Correspondence to Jarno E.J. Wolters, University Eye Clinic Maastricht, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre + (MUMC+), P.O. Box 5800, Maastricht, The Netherlands. +. Tel: 31 43 3875406; e-mail: [email protected]; Theo G.M.F. Gorgels, University Eye Clinic Maastricht, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre + (MUMC+), P.O. Box 5800, Maastricht, The Netherlands. Tel: +31 43 3871565; e-mail: [email protected] Current Opinion in Ophthalmology 32(2):p 148-159, March 2021. | DOI: 10.1097/ICU.0000000000000729 Buy Metrics Abstract Purpose of review Mitomycin C (MMC) is an alkylating agent with extraordinary ability to crosslink DNA, preventing DNA synthesis. By this virtue, MMC is an important antitumor drug. In addition, MMC has become the gold standard medication for glaucoma filtration surgery (GFS). This eye surgery creates a passage for drainage of aqueous humor (AqH) out of the eye into the sub-Tenon's space with the aim of lowering the intraocular pressure. A major cause of failure of this operation is fibrosis and scarring in the sub-Tenon's space, which will restrict AqH outflow. Intraoperative application of MMC during GFS has increased GFS success rate, presumably mainly by reducing fibrosis after GFS. However, still 10% of glaucoma surgeries fail within the first year. Recent findings In this review, we evaluate risks and benefits of MMC as an adjuvant for GFS. In addition, we discuss possible improvements of its use by adjusting dose and method of administration. Summary One way of improving GFS outcome is to prolong MMC delivery by using a drug delivery system. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.