FAT ADHERENCE SYNDROME TREATED WITH INTRAOPERATIVE MITOMYCIN-C - A RABBIT MODEL

We used an animal model of restrictive strabismus analogous to the fat adherence syndrome in humans to test the efficacy of topical intraope rative mitomycin-C (MMC) in preventing the development of restrictive scar tissue. A cicatricial adhesion was created between the inferior r ectus muscle and the inferior orbital rim of each eye in eight rabbits , and passive forced ductions were quantitatively measured with a spri ng scale. Eight eyes were treated intraoperatively with topical MMC 0. 5 mg/mL, the other eight with sterile water. Passive forced ductions w ere again measured 4 weeks postoperatively and representative orbits w ere exenterated for histopathologic examination. Significant restricti on of motility was produced in six of the eight control eyes. Though p rophylactic treatment with MMC may have been beneficial in some cases, on average, the restriction developing in these eyes did not signific antly differ from that in the control eyes. In addition, longer exposu re times to MMC led to marked orbital inflammation and severe restrict ion of ocular motility. Finally, histopathologic evaluation of the orb its of the MMC-treated eyes revealed marked fibrosis of perimuscular c onnective tissues. Although MMC may have a role in the management of f at adherence syndrome, further study is needed to establish safe and e fficacious methods of delivery.