Mitomycin C for trabeculectomy accounted for over a third of off-label ophthalmology prescriptions.
Off-label prescribing in ophthalmology: a retrospective analysis.
Claudio Bucolo … Federica Conti
Frontiers in pharmacology · 2026
Background
Off-label practice is often needed in ophthalmology, due to the limited number of drugs approved to treat several ocular diseases and to manage challenging ocular surgeries.
Results
34.3%
Mitomycin C, used in glaucoma surgery, made up over one-third of all off-label prescriptions.
n = 225 patients
More results
233 off-label prescriptions, comprising 13 drugs, were delivered to treat 225 patients affected by ocular disorders.
After a decrease in 2017-2018, there was an increasing trend in the number of off-label issued prescriptions until 2024.
More results
The main contributors were anti-vascular endothelial growth factor (VEGF) drugs such as bevacizumab, ranibizumab and aflibercept, which represent 25.3%, 9.0% and 4.3% of off-label prescriptions, respectively.
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Conclusion
Collaboration among regulatory authorities, clinicians, marketing authorization holders, and patients is essential, in order to develop standardized, evidence-based international guidelines about off-label use, to improve outcome of patients with unmet medical needs.