Mitosol Kit for Ophthalmic Use

Finally, a Mitomycin that has it all!

Archives for April 2017

How to handle a Mitosol Spill?

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On the sterile field:

  1. Place a disposable towel or small stack of 4x4s onto the spill and allow it to be absorbed.
  2. Place in yellow chemotherapy disposal bag.
  3. Gloves must be changed after cleaning a spill.
  4. Place used gloves in yellow chemotherapy bag.

Off the sterile field:

  1. Don gloves.
  2. Place disposable towel onto the spill and allow it to be absorbed.
  3. Wipe area of spill with a bleach wipe.
  4. Place towel and bleach wipe into yellow chemotherapy disposal bag.
  5. Remove gloves and place in yellow bag.
  6. Wash hands.

WMI-039 Rev 01/2018

Why is Mitosol used during a trabeculectomy procedure?

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Over time, the sclera and the conjunctiva eventually “scar up” and the bleb is no longer functional.

Mitosol and Trabeculectomy

Trabeculectomy is performed to treat glaucoma, a disease that causes blindness due to increased pressure on the optic nerve caused by compromised outflow of aqueous humor from the anterior chamber of the eye. A portion of the trabecular meshwork is removed by the surgeon to create a bypass drain for the aqueous humor. The surgeon cuts the conjunctiva and separates it from the sclera, then creates a scleral flap to access the trabecular meshwork underneath. Once the portion of the trabecular meshwork is removed, aqueous outflow is established. The aqueous collects in the space between the sclera and conjunctiva, creating a bleb, where it is reabsorbed by the body.

Why Mitosol?

Mitosol is Mitomycin C, an antimetabolite ( a chemotherapy agent) that destroys the fibroblasts that cause scarring of those tissues. The surgeon applies Mitosol between the sclera and conjunctiva to target the fibroblasts and prevent bleb failure.

WMI-035 Rev 01/2018

Does the contraindication for pregnancy include pregnant health care workers who work with Mitosol?

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Unfortunately, safe use during pregnancy has not been established.  The following is a statement from the American Academy of Ophthalmology regarding use of MMC in pregnant/lactating patients.

“Mitomycin C is an antifibrotic agent which is frequently applied in glaucoma surgery. A decrease of mean litter size and body weight and an increase of exencephaly in second gestation mice were associated with mitomycin use.29 There are no studies reporting the teratogenic effect of this drug in the human fetus, though the mechanism of action of the drug strongly suggests a possible teratogenic risk.” -EyeWiki

Although this addresses use in pregnant patients, the issue is exposure to the drug.  The Mitosol kit is designed to make the use of MMC in the operating room as safe as possible, however, there is always a potential for exposure, either by contact or inhalation.  Therefore, we recommend that pregnant or nursing health care workers avoid working with it if possible.  Due to the lack of information on chemotherapy and pregnant healthcare workers, our advice is it’s better to be safe than sorry.

WMI-038 Rev 01/2018