Cruz O A
Anheuser-Busch Eye Institute, St Louis University School of Medicine, MO, USA.
J Pediatr Ophthalmol Strabismus. 1996 Mar-Apr;33(2):89-92. doi: 10.3928/0191-3913-19960301-06.
Ocular motility dysfunction following strabismus surgery may be the result of postoperative scarring or the formation of adhesions. Mitomycin C (MMC) has been used with encouraging results as an adjunct to standard treatment of hypertrophic conjunctival scars after strabismus surgery. It has been demonstrated that MMC does not inhibit muscle reattachment and might inhibit adhesions and scar formation in the rabbit. We investigated in a rabbit model effectiveness of MMC in reducing the formation of postoperative adhesions following reoperations and the tensile strength of the new musculo-scleral junction.
A prospective, masked-observer, controlled study was performed in rabbits. Symmetrical bilateral recessions of the superior and inferior rectus muscles were performed on each rabbit. A reoperation was performed 6 weeks later, in which the muscles were advanced back to their original insertion. During the reoperation, one eye served as the control while the other was treated with a 5-minute intraoperative exposure to topical mitomycin.
Mitomycin reduced the formation of adhesions and the amount of postoperative scarring. The tensile strength of the musculo-scleral junction was reduced in the mitomycin-treated eyes but exceeded the force generated during extraocular ductions.
MMC may be an effective adjunctive therapy in the treatment of strabismus associated with pre-existing adhesions or scarring.
斜视手术后的眼球运动功能障碍可能是术后瘢痕形成或粘连所致。丝裂霉素C（MMC）作为斜视手术后肥厚性结膜瘢痕标准治疗的辅助药物使用，取得了令人鼓舞的效果。已证实MMC不会抑制肌肉重新附着，且可能抑制兔体内粘连和瘢痕形成。我们在兔模型中研究了MMC在减少再次手术后术后粘连形成及新的肌巩膜连接处抗张强度方面的有效性。
对兔进行了一项前瞻性、双盲观察者对照研究。在每只兔身上对称地进行上、下直肌双侧后徙术。6周后进行再次手术，将肌肉重新推进到其原来的附着处。再次手术期间，一只眼作为对照，另一只眼在术中接受5分钟局部丝裂霉素暴露处理。
丝裂霉素减少了粘连形成和术后瘢痕量。丝裂霉素处理眼的肌巩膜连接处抗张强度降低，但超过了眼外肌运动时产生的力量。
MMC可能是治疗伴有既有粘连或瘢痕的斜视的一种有效辅助疗法。
