丝裂霉素C与Viscoat对兔延迟可调斜视手术效果的比较。

Comparison of the effectiveness of mitomycin-C and Viscoat on delayed adjustable strabismus surgery in rabbits.

作者信息

Cengiz Y, Altintas O, Manav Ay G, Cağlar Y

机构信息

Department of Ophthalmology, School of Medicine, University of Kocaeli, Izmit, Turkey.

出版信息

Eur J Ophthalmol. 2005 Sep-Oct;15(5):530-5.

PMID:16167282

Abstract

PURPOSE

To determine a way to prevent the formation of adhesions and delay the time of suture adjustment in the course of adjustable strabismus surgery, an animal study was performed to assess and compare the effects of mitomycin C (Mit-C) and viscoelastic material Viscoat (sodium hyaluronate 3% and chondroitin sulphate 4%, Alcon, Fort Worth, TX).

METHODS

Right eyes of 47 rabbits were divided into three groups. After recession of the superior rectus muscle (SRM), Mit-C was administered beneath and over the SRM in Group M (16 eyes), Viscoat was administered beneath and over SRM in Group V (16 eyes), and ringer lactate was administered in Group C (15 eyes). SRM then recessed 5 mm with adjustable strabismus surgery technique. Animals in each group were subdivided into 1 and 2, where 1 = adjustment 1 week postoperatively and 2 = adjustment 3 weeks postoperatively. Delayed adjustment was performed in M1 group (6 eyes), V1 group (6 eyes), and C1 group (7 eyes) after 1 week; in M2 group (6 eyes), V2 group (6 eyes), and C2 group (6 eyes) after 3 weeks. Histopathologic examinations were performed for the remaining 10 eyes without suture adjustment at the end of first and third weeks after adjustable strabismus surgery. The possible length and the necessary force to adjust and the degree of adhesions were recorded.

RESULTS

When length and strength of the adjustment, adhesions between muscle and sclera, and adhesions between muscle and conjunctiva were taken into consideration, there was no statistically significant difference among M, V, and C groups at postoperative weeks 1 and 3. The force needed for adjustment in M1 group was statistically lower than M2 group. CONCLUSIONS. The intraoperative use of Mit-C (0.4 mg/mL) may decrease adhesion formation in the early postoperative period, especially in the first week. The intraoperative use of Viscoat was not effective in reducing postoperative adhesions and delaying adjustment.

摘要

目的

为了确定在可调性斜视手术过程中预防粘连形成和延迟缝线调整时间的方法，进行了一项动物研究，以评估和比较丝裂霉素C（Mit-C）和粘弹性材料Viscoat（3%透明质酸钠和4%硫酸软骨素，爱尔康公司，沃思堡，德克萨斯州）的效果。

方法

47只兔子的右眼被分为三组。在直肌后退术后，M组（16只眼）在直肌下方和上方给予Mit-C，V组（16只眼）在直肌下方和上方给予Viscoat，C组（15只眼）给予乳酸林格液。然后采用可调性斜视手术技术将直肌后退5mm。每组动物再分为1组和2组，其中1组 = 术后1周进行调整，2组 = 术后3周进行调整。M1组（6只眼）、V1组（6只眼）和C1组（7只眼）在1周后进行延迟调整；M2组（6只眼）、V2组（6只眼）和C2组（6只眼）在3周后进行延迟调整。在可调性斜视手术后第一周和第三周结束时，对其余10只未进行缝线调整的眼睛进行组织病理学检查。记录调整的可能长度、所需力量以及粘连程度。

结果

考虑到调整的长度和强度、肌肉与巩膜之间的粘连以及肌肉与结膜之间的粘连，M、V和C组在术后第1周和第3周时无统计学显著差异。M1组调整所需的力量在统计学上低于M2组。结论：术中使用Mit-C（0.4mg/mL）可能会减少术后早期尤其是第一周的粘连形成。术中使用Viscoat在减少术后粘连和延迟调整方面无效。