Explore the vast range of titles available.

Purpose: To determine the safety and efficacy of mitomycin C (MMC) injection versus sponge during trabeculectomy. Methods: It is a prospective analysis of patients who underwent trabeculectomy with MMC and followed up for 1 year, divided into two groups, namely, group 1- injection (n = 21), group 2-> sponge (n = 21). The same concentration of MMC was used for both groups. Inclusion criteria were trabeculectomies with MMC for intraocular pressure (IOP) control in eyes with glaucoma (primary + secondary) with a follow-up of 1 year. Results: Mean preoperative IOP in group 1 was 29.00 ± 11.92 mmHg and group 2 was 25.87 ± 11.09 mmHg, which reduced to 12.19 ± 4.03 and 15.56 ± 10.72 mmHg at final visit with P value of 0.0002 and 0.001, respectively. Mean preoperative number of antiglaucoma medications was 2.4 ± 0.87 in group 1 and 2.3 ± 0.96 in group 2, which reduced to 0.38 ± 0.5 and 0.91 ± 0.85 with P value of 0.001 and 0.0003, respectively. The complete success rate was 52.4% in the injection group and 26.1% in the sponge group at end of 1 year. Overall, success rate (complete + qualified) was 90.5% and 87% in group 1 and group 2 at final visit. All major complications were encountered in sponge group. 1 (11.1%) patient developed choroidal detachment and one had malignant glaucoma which got resolved by medical management. 33.3% cases had encapsulated bleb which received bleb needling. 44.4% cases underwent Argon laser suture lysis postoperatively. Conclusion: The MMC injection may be as safe and as effective as conventional sponge application with comparable estimated complete treatment success.

Background: The introduction of mitomycin C (MMC) as an adjunct to trabeculectomy was a major advance in the ability to improve the Intra ocular pressure lowering efficiency of the procedure. The time tested traditional way of administration of MMC is via a sponges soaked in it, duration and concentration varies depending on risk of failure. A subconjunctival injection of MMC instead of these sponges is recently being used as a promising alternative. Purpose: Here is the video demonstrating the 2 possible ways to prepare and apply MMC during a trabeculectomy surgery. Synopsis: Intraoperative injection of MMC in trabeculectomy has several advantages over conventional method ofsponge application. A large MMC treatment area produces more diffuse and elevated blebs. Large-area MMC application also seems to increase long-term success without increasing the complication rates in trabeculectomies. Direct and diffuse application of MMC by injection may promote less scarring and vascularization of the bleb. To achieve the same surface area of exposure with sponges, i.e.achieved with injection, the surgeon must use multiple sponges, all of which must be carefully collected thereafter. The injection method,therefore,eliminates the risk of retained sponges. Highlights: injection of MMC may be as safe and as effective as conventional sponge application of MMC with comparable estimated complete treatment success with relatively lower complication rates. Video link: https://youtu.be/RLEbK4IeRtU Key words: Injectable mitomycin C, sponge-soaked mitomycin C, trabeculectomy

Purpose To evaluate the effect of postoperative interferon-alpha 2b (IFN-α2b) ophthalmic drops versus intraoperative mitomycin-c (MMC) on preventing pterygium recurrence. Methods This prospective randomized clinical trial was conducted on patients who were candidates for pterygium surgery. A total of 75 patients were included in the study from December 2021 to December 2022, of which 64 patients (one eye each) were examined and analyzed based on the inclusion criteria. Then the patients were randomly assigned to control groups, intra-operative MMC (32 patients) and the intervention group, IFN-α2b drops after the operation (32 patients). All patients underwent pterygium surgery using the rotational conjunctival flap method. Results In terms of pterygium grading, 8 (12.5%), 25 (39.06%), and 31 (48.44%) eyes were in grades 1, 2, and 3, respectively. The average size of the pterygium was 3.6 ± 0.7 mm. The grade and size of pterygium had the same distribution in the two groups. There was no statistically significant difference between the two groups in the level of post-operative clinical inflammation. The present study showed no significant difference in complications between the two groups ( p  = 0.999). The recurrence rate in the control group was 9.4% (3 eyes), and 0% (no recurrence) in the intervention group ( p  = 0.119). Conclusions interferon-alpha 2b group did not show a statistically significant difference in preventing pterygium recurrence compared to the mitomycin C group. The post-surgery administration of IFN-α 2b drops can effectively prevent pterygium recurrence with a comparable and even more compelling effect than MMC during surgery. Key message What is known: • Mitomycin-C is applied intra-operatively to reduce the recurrence risk of pterygium. What is new: • Interferon alpha-2b drops after pterygium surgery can prevent pterygium recurrence with a comparable effect and maybe even more effective than MMC during surgery. • There was no statistically significant difference between the intraoperative MMC and postoperative IF alpha-2b groups in the level of post-operative clinical inflammation and complications.

Conjunctival malignant melanoma is a pigmented lesion of the ocular surface. It is an uncommon but potentially devastating tumor that may invade the local tissues of the eye, spread systemically through lymphatic drainage and hematogenous spread, and recur in spite of treatment. Despite its severity, the rarity of available cases has limited the evidence for diagnosis and management. This review will provide an overview of the epidemiology, risk factors, presentation, diagnosis, management, prognosis, staging, and surveillance of conjunctival melanoma, with an emphasis on recent advances in biological therapies to treat this disease.

Neutrophils play a critical role in the cancer-immunity cycle and are associated with poor clinical outcomes. Recent research has primarily focused on the targeted delivery, phenotypic reversal, and reprogramming of tumor-associated neutrophils, while the impact of disease-associated neutrophils (DANs) on antitumor therapy remains understudied. Since liposomes, as drug delivery carriers, possess excellent biocompatibility and stability, making them particularly suitable for combination therapy, we optimized the formulation of asymmetrically branched polyethylene glycol-modified mitomycin C lipid prodrug liposomes (PEG 2,5 K @MLP-L) and prepared hyaluronic acid and sialic acid ester stearate-co-modified dexamethasone palmitate liposomes (HA*SAS@DXP-L) to study DANs in normal, obese, aged, and septic mice. An increase in mitochondria and lysosomes in Ly-6G + CXCR2 high DANs accelerated drug clearance, reduced CD3 + CD8 + T cell activity in tumor-draining lymph nodes, and decreased CD8 + T cell infiltration in tumors. As the proportion of DANs increased, the efficacy of PEG 2,5 K @MLP-L decreased. Combination therapy with PEG 2,5 K @MLP-L and HA*SAS@DXP-L can reshape DANs, promote the cancer-immunity cycle, and enhance treatment efficacy. This study identifies key characteristics and functions of DANs and presents a promising strategy for improving clinical outcomes. Graphical Abstract

Background: Non-muscle-invasive bladder cancer (NMIBC) comprises about 75% of all bladder cancers. Although NMIBC is treatable, it poses significant costs and burdens to patients due to high recurrence rates. We conducted an updated meta-analysis of studies that evaluated the efficacy of and outcomes after treatment with mitomycin C (MMC), gemcitabine (GEM), and docetaxel (DOCE) for NMIBC recurrence and progression. Methods: We searched the PubMed and Cochrane databases for observational cohort studies and randomized clinical trials (RCT) conducted between 2009 and 2022 that assessed the efficacy of GEM, DOCE, or MMC, alone or in combination, regarding NMIBC outcomes. A total of 49 studies that met the inclusion criteria were reviewed for their quality, sample size, outcomes, and potential for bias, and relevant data were extracted for the meta-analysis. Separate meta-analyses were performed to assess the risks of recurrence or progression when comparing GEM/DOCE or MMC vs. other treatments. Study heterogeneity was assessed by I2 statistics. Results: Among 31 studies comparing GEM or MMC to other treatments for NMIBC recurrence, there were statistically significant risk reductions of 24% for GEM (pooled relative risk (RR) of 0.76; 95% confidence interval (CI) 0.64–0.87) and 37% for MMC (pooled RR = 0.63; 95% CI 0.58–0.68). Recurrence-free survival (RFS) for GEM or MMC alone was 69.5% (95% CI 66.6–72.3%) and 67.2% (95% CI 66.2–68.2%), respectively. Studies assessing the combination of treatments had a pooled RFS of 44.6% (95% CI 40.4–48.7%). Fewer studies examined the risk of NMIBC progression, with large variability and inconclusive results across them. Conclusions: Our findings corroborate recent guidelines indicating that both GEM and MMC are effective treatments that reduce tumor recurrence and improve survival of NMIBC, although with large variability across the studies. Fewer studies evaluated DOCE treatment, with inconclusive results. Women and minorities were generally underrepresented, raising concerns about the generalizability of the findings and highlighting the importance of including a broader patient population in future RCTs.

PurposeTo evaluate the indications, outcomes, and complications of the usage of Aurolab Aqueous Drainage Implant (AADI) using mitomycin-C.MethodsA retrospective case series of patients who underwent AADI placement using mitomycin-C between April 2018 and June 2020 at Ain Shams University Hospitals, Cairo, Egypt. The data was extracted from the records of the patients with a minimum of 1 year of follow-up. Complete success was defined as IOP ≥ 5 mmHg and ≤ 21 mmHg or reduction of IOP by ≥ 20% from baseline without antiglaucoma medications (AGMs). Qualified success was defined as reaching the same IOP range with the aid of AGM.ResultsA total of 50 eyes of 48 patients were included. Neovascular glaucoma represented the commonest indication (13 patients, 26%). The mean preoperative IOP was 34.0 ± 7.1 mmHg, with a median number of AGM of 3 (mean ± SD = 2.84 ± 1), while the mean IOP after 12 months was 14.3 ± 4 with a median number of AGM of 0. (mean ± SD = 0.52 ± 0.89) (p < 0.001). Complete success was achieved in 33 patients (66%). Qualified success was achieved in 14 patients (28%). Thirteen eyes (26%) had variable postoperative complications; none of them required explantation of the device or affected the visual acuity (except one patient).ConclusionAADI with using mitomycin-C and ripcord during the surgery is an effective and relatively safe method of control of IOP in refractory and advanced cases of glaucoma, with an overall success rate of 94%.

Purpose To evaluate the efficacy and safety of using Mitomycin-C (MMC) or Ologen implant as an adjunct to combined trabeculotomy–trabeculectomy (CTT) surgery relative to non-augmented CTT surgery in achieving higher success rates in patients with primary congenital glaucoma (PCG). Study design A prospective triple-armed randomized controlled clinical trial was conducted in the period between April 2019 and May 2021, targeting 75 eyes of patients with PCG over one year, with patients being followed up for at least one whole year. Patients and methods The study included 75 eyes; only 70 fulfilled the inclusion criteria and were randomly assigned to one of the three study groups using a computer program to generate random number list. Eyes were treated by either CTT without augmentation, CTT augmented with MMC, or CTT augmented with Ologen implant. Only 63 eyes completed one year of follow-up and were evenly distributed among the three study groups; with 21 eyes in each group were statistically analyzed. Outcome measures Our primary outcome measure is to report and compare the percentage of patients who demonstrated complete success with intraocular pressure (IOP) controlled and maintained below 21 mmHg without the use of antiglaucoma medications or additional glaucoma surgery over a one-year follow-up. Secondary outcome measures include reporting failure, intra- and postoperative complications of the three surgical modalities, postoperative corneal diameter, clearance of corneal edema, and postoperative cup/disk ( C / D ) ratio. Results Complete success was achieved in 17 eyes (81.0%) in CTT group, 18 eyes (85.7%) in MMC group, and 17 eyes (81.0%) in Ologen group. Qualified success (IOP < 21 with or without antiglaucoma medications) was achieved in 18 eyes (85.7%) in both the CTT and the Ologen groups, with 19 eyes (90.5%) in the MMC group. Failure was observed in three eyes (14.3%) in both CTT and Ologen groups and two eyes (9.5%) in the MMC group. Based on survival analysis, CTT group had a cumulative success probability of 95.2% at three months, which dropped to 85.7% at six months and remained at that level for the 9th and 12th months of follow-up. With respect to the MMC group, the cumulative success probability at three months was 95.2%, dropped to 90.5% at six months, and remained at that level for the 9th and 12th months of follow-up. While in the Ologen group, the cumulative success probability at three months was 85.7% and remained at the same level during the 6th, 9th, and 12th months of follow-up, with p value = 0.862 using the logrank test. Conclusion CTT is a safe and effective primary surgical intervention in patients with PCG without the need for augmentation while preserving the augmented procedure's use for recurrent cases.

Abstract PurposeMyopic glaucoma patients display a considerable risk of complications following antiglaucomatous filtering surgery, e.g., trabeculectomy. Canaloplasty with mitomycin C may reduce this risk by avoiding massive overfiltration.MethodsWe performed retrospective analysis of 31 eyes with myopia that underwent canaloplasty modified with mitomycin C in a consecutive single-surgeon case series. Annual data and success rates were analysed. Twenty-three myopic eyes that had received conventional trabeculectomy with mitomycin C were recorded as a comparison.ResultsThe 31 eyes with a follow-up of 40 ± 26 months after canaloplasty had a mean spherical equivalent of − 8.4 ± 4.5 dioptres. Intraocular pressure decreased from 32.3 ± 9.6 mmHg (range: 17 to 58) to 16.8 ± 8.1 mmHg (range: 5 to 44) 1 year after surgery (− 46%; p < 0.001) with a medication score reduction from 5 to 1.2 (p < 0.001). Qualified success rates (Criterion B: no revision surgery, IOP < 21 mmHg, IOP reduction > 20%) were 83% after 1 year and 61% at the 2nd and 3rd years. In 5 eyes (16%), early ocular hypotony (≤ 5 mmHg) was observed. Two eyes (7%) showed transient choroidal detachment and swelling. The 23 eyes that had received trabeculectomy had success rates (Criterion B) of 91% at the 1st and 86% at the 2nd and 3rd years. Hypotony occurred in 10 eyes (44%), and 4 eyes (17%) showed choroidal detachment or macular folds.ConclusionsPostoperative complications related to overfiltration were less frequent after canaloplasty with mitomycin C. Midterm data proved good efficacy. Pressure reduction, success rates and rates of medication free patients were significantly higher in trabeculectomy compared to modified canaloplasty with mitomycin C.

Breast cancer type 2 susceptibility (BRCA2) protein is crucial for initiating DNA damage repair after chemotherapy with DNA interstrand crosslinking agents or X-ray irradiation, which induces DNA double-strand breaks. BRCA2 contains a C-terminal RAD51-binding domain (CTRBD) that interacts with RAD51 oligomer-containing nucleofilaments. In this study, we investigated CTRBD expression in cells exposed to X-ray irradiation and mitomycin C treatment. Surprisingly, BRCA2 CTRBD expression in HeLa cells increased their resistance to X-ray irradiation and mitomycin C. Under endogenous BRCA2 depletion using shRNA, the sensitivities of the BRCA2-depleted cells with and without the CTRBD did not significantly differ. Thus, the resistance to X-ray irradiation conferred by an exogenous CTRBD required endogenous BRCA2 expression. BRCA2 CTRBD-expressing cells demonstrated effective RAD51 foci formation and increased homologous recombination efficiency, but not nonhomologous end-joining efficiency. To the best of our knowledge, our study is the first to report the ability of the BRCA2 functional domain to confer resistance to X-ray irradiation and mitomycin C treatment by increased homologous recombination efficiency. Thus, this peptide may be useful for protecting cells against X-ray irradiation or chemotherapeutic agents.