Comparison of the effectiveness of mitomycin-C and Viscoat on delayed adjustable strabismus surgery in rabbits.
OBJECTIVE
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.
Cengiz
Y
Y
Department of Ophthalmology, School of Medicine, University of Kocaeli, Izmit, Turkey.
Altintas
O
O
Manav Ay
G
G
Cağlar
Y
Y
D000818:Animals; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D002807:Chondroitin / Q000008:administration & dosage*; D002809:Chondroitin Sulfates; D003229:Conjunctival Diseases / Q000517:prevention & control; D004338:Drug Combinations; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007430:Intraoperative Care / Q000379:methods; D016685:Mitomycin / Q000008:administration & dosage*; D009801:Oculomotor Muscles / Q000187:drug effects* / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control*; D011817:Rabbits; D015422:Scleral Diseases / Q000517:prevention & control; D013285:Strabismus / Q000601:surgery*; D013536:Suture Techniques; D013997:Time Factors; D000267:Tissue Adhesions / Q000517:prevention & control
D000903:Antibiotics, Antineoplastic; D004338:Drug Combinations; C501944:chondroitin sulfate, sodium hyaluronate drug combination; D016685:Mitomycin; D006820:Hyaluronic Acid; D002807:Chondroitin; D002809:Chondroitin Sulfates