Do you think Mitomycin C is safe

[OphthoBean]

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Do you think it is safe for a pregnant female to operate with MMC as is done with pterygium and glaucoma procedures? Has anyone heard anything or know of anyone who might know?

 

[Olddog1]

If it were me I would stop using MMC the day I found out I was pregnant. Why risk it? Unless you are a high volume glaucoma specialist I doubt you would lose that much income. However, if you lost the baby, or there were abnormalities ,you would always be asking yourself if it was the MMC. I would not worry as much about applying the MMC, it is the rinsing off step that can sometimes get a little messy. Do SLTs, tubes and put off the pterygium surgery or refer. FYI: at two institutions we had scrub nurses get pregnant and they were not allowed in the room on any trabs with MMC (not my rule, it was the OR's).

 

[Mirror Form]

Do SLTs, tubes and put off the pterygium surgery or refer.

Exactly, just do baerveldt's instead of trabs. And you can always refer out your pterygiums. Why take the chance when there are easy ways around it?

 

[Wolverine98]

Exactly, just do baerveldt's instead of trabs. And you can always refer out your pterygiums. Why take the chance when there are easy ways around it?

Not only that, but you have to consider the urgency of the situation. How many emergent pterygiums do you do? Tell the patient why you don't want to do the surgery at that time, and give them the option of waiting until you've delivered or seeing someone else.

With trabs it's a little different, but even then, most trabs that you do aren't trule emergent. Many people will lean towards tubes in those situations, especially since they are often uveitic or neovascular situations. Most patients who are going to get a straight trab can be delayed for a few months.
If the concern is that the tube won't get you a low enough pressure (very legitimate concern, especially with the early TvT data), you could either refer the patient out or combine a tube with ECP if the patient is pseudophakic.

The fact is, it's probably safe from the operating side for you to use MMC, but I agree with Olddog that if you do that, and something goes wrong, you're always going to wonder if that was the reason.

Dave

 

[Andrew_Doan]

Unless you're going to inhale or injest the Mitomycin C, I think it's safe to use. You're wearing a surgical gown, gloves, mask, and head cover. If using Weck cells soaked in MMC to apply it to the eye, then you really don't get it all over you. It only touches the instruments, patient's eye, and Weck cells. You also rinse copiously with water.

I think it's safe if you use standard surgical precautions.