Q.1 Which of the following classification systems is used for grading the bleb?
A) Indiana Bleb Appearance Grading Scale
B) Moorfields Bleb Grading System
C) Wuerzburg bleb classification system
D) All of the above
Q.2 Mitomycin C is isolated from which of the following?
A) Recombinant DNA
B) Streptomyces caespitosus
C) Papaver Somniferum
D) All of the above
Q.3 Side effects of Mitomycin C?
A) Bleb leakage
B) Endophthalmitis
C) cystic bleb
D) All of the above
Q.4 Other use of mitomycin C in ophthalmology other than trabeculectomy?
A) Pterygium surgery
B) Conjunctival neoplasia
C) Cicatricial eye disease
D) All of the above
Q.1 Ans D
Parameters and scores of the three bleb classification systems: Indiana Bleb Appearance
Grading Scale, Moorfields Bleb Grading System, and the Picht and Grehn/ Wuerzburg bleb
classification system.
Bouremel, Yann; Lee, Richard M. H.; Eames, Ian; Brocchini, Steve; Khaw, Peng Tee (2019):
Parameters and scores of the 3 bleb classification systems: Indiana Bleb Appearance Grading
Scale, the Moorfields Bleb Grading System, and the Picht and Grehn/Wuerzburg bleb
classification system. PLOS ONE. doi.org/10.1371/journal.pone.0221715.t001
Klink T, Kann G, Ellinger P, Klink J, Grehn F, Guthoff R: The Prognostic Value of the Wuerzburg Bleb Classification Score for the Outcome of Trabeculectomy. Ophthalmologica 2011;225:55-60. doi: 10.1159/000314717
Q.2 Ans B
Mitomycin C is an antineoplastic/antibiotic agent isolated from the soil bacterium
Streptomyces caespitosus. It is an anti-metabolite with an anti-proliferative effect on cells showing the
highest rate of mitosis by inhibiting DNA synthesis and interfering with RNA transcription and protein
synthesis. Morphine and aspirin are purely natural and semi-synthetic products derived from the
opium poppy (Papaver somniferum), and from willow bark, respectively.
Mearza AA, Aslanides IM. Uses and complications of mitomycin C in ophthalmology. Expert
Opin Drug Saf. 2007 Jan;6(1):27-32. doi: 10.1517/14740338.6.1.27. PMID: 17181449.
Q.3 Ans D
The complications of antifibrotic agents are corneal epithelial toxicity, thin cystic
avascular bleb, hypotony, bleb leak, and endophthalmitis. MMC has been shown to cause marked corneal
endothelial loss, corneal stromal necrosis, anterior chamber reaction, and hemorrhagic iris necrosis in animal studies.
Ali A Mearza & Ioannis M Aslanides (2007) Uses and complications of mitomycin C in
ophthalmology, Expert Opinion on Drug Safety, 6:1, 27-32, DOI: 10.1517/14740338.6.1.27
Q.4 Ans D
Current applications of mitomycin C include pterygium surgery, glaucoma surgery,
corneal refractive surgery, cicatricial eye disease, conjunctival neoplasia, and allergic eye
disease.
Ali A Mearza & Ioannis M Aslanides (2007) Uses and complications of mitomycin C in
ophthalmology, Expert Opinion on Drug Safety, 6:1, 27-32, DOI: 10.1517/14740338.6.1.27