Intraoperative sponge 5-fluorouracil to reduce postoperative scarring in strabismus surgery.
BACKGROUND
To determine whether 5-fluorouracil is effective in reducing scarring after strabismus surgery we used rectus muscle surgery in experimental animals to compare a single intraoperative dose of 5-fluorouracil with mitomycin C and to compare results in similarly treated controls not receiving these antimetabolites.


METHODS
Muscle resections were performed on eight rabbits (16 eyes). Four eyes had 5-fluorouracil (50 mg/ml), and four eyes received mitomycin C (0.2 mg/ml), each of which was applied during surgery on an ophthalmic sponge for 5 minutes. Eight eyes served as controls. Six weeks after surgery conjunctival vascularity, muscle length-tension curves, muscle disinsertion force, and the histologic degree of scarring were assessed.


RESULTS
The mitomycin C-treated eyes clearly had more conjunctival avascularity and a lower disinsertion force. Both treated groups had flatter length-tension curves and less scarring on histologic examination than the control eyes.


CONCLUSIONS
Antifibroproliferative therapy with intraoperative sponge 5-fluorouracil appears as effective as, and is possibly safer than, mitomycin C. It may be a useful adjunct in recurrent strabismus surgery or in other situations where a risk of excessive postoperative scarring exists.
Mora
J S
JS
Department of Ophthalmology, Indiana University, Indianapolis 46202-5175, USA.
Sprunger
D T
DT
Helveston
E M
EM
Evan
A P
AP
D000287:Administration, Topical; D000818:Animals; D000963:Antimetabolites / Q000008:administration & dosage / Q000627:therapeutic use*; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control*; D003228:Conjunctiva / Q000187:drug effects / Q000473:pathology; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use*; D007432:Intraoperative Period; D016685:Mitomycin / Q000008:administration & dosage / Q000627:therapeutic use; D009801:Oculomotor Muscles / Q000601:surgery*; D011183:Postoperative Complications / Q000473:pathology / Q000517:prevention & control*; D011817:Rabbits; D011897:Random Allocation; D012590:Sclera / Q000187:drug effects / Q000473:pathology; D013285:Strabismus / Q000601:surgery*; D015503:Surgical Sponges; D014945:Wound Healing / Q000187:drug effects
D000963:Antimetabolites; D016685:Mitomycin; D005472:Fluorouracil