Brooks S E, Ribeiro G B, Archer S M, Elner V M, Del Monte M A
Department of Ophthalmology, Medical College of Georgia, Augusta 30912, USA.
J Pediatr Ophthalmol Strabismus. 1996 Jan-Feb;33(1):21-7. doi: 10.3928/0191-3913-19960101-07.
We used an animal model of restrictive strabismus analogous to the fat adherence syndrome in humans to test the efficacy of topical intraoperative mitomycin-C (MMC) in preventing the development of restrictive scar tissue. A cicatricial adhesion was created between the inferior rectus muscle and the inferior orbital rim of each eye in eight rabbits, and passive forced ductions were quantitatively measured with a spring scale. Eight eyes were treated intraoperatively with topical MMC 0.5 mg/mL, the other eight with sterile water. Passive forced ductions were again measured 4 weeks postoperatively and representative orbits were exenterated for histopathologic examination. Significant restriction of motility was produced in six of the eight control eyes. Though prophylactic treatment with MMC may have been beneficial in some cases, on average, the restriction developing in these eyes did not significantly differ from that in the control eyes. In addition, longer exposure times to MMC led to marked orbital inflammation and severe restriction of ocular motility. Finally, histopathologic evaluation of the orbits of the MMC-treated eyes revealed marked fibrosis of perimuscular connective tissues. Although MMC may have a role in the management of fat adherence syndrome, further study is needed to establish safe and efficacious methods of delivery.
我们使用了一种类似于人类脂肪粘连综合征的限制性斜视动物模型，以测试术中局部应用丝裂霉素-C（MMC）预防限制性瘢痕组织形成的疗效。在8只兔子的每只眼睛的下直肌和眶下缘之间形成瘢痕粘连，并用弹簧秤定量测量被动牵拉试验。8只眼睛术中局部应用0.5mg/mL的MMC治疗，另外8只眼睛用无菌水治疗。术后4周再次测量被动牵拉试验，并对代表性眼眶进行眼球摘除术以进行组织病理学检查。8只对照眼中有6只出现明显的运动受限。虽然MMC预防性治疗在某些情况下可能有益，但平均而言，这些眼睛出现的受限情况与对照眼相比无显著差异。此外，MMC暴露时间延长会导致明显的眼眶炎症和严重的眼球运动受限。最后，对MMC治疗眼的眼眶进行组织病理学评估发现肌周结缔组织明显纤维化。虽然MMC可能在脂肪粘连综合征的治疗中发挥作用，但需要进一步研究以建立安全有效的给药方法。
