MITOMYCIN IN THE TREATMENT OF HYPERTROPHIC CONJUNCTIVAL SCARS AFTER STRABISMUS SURGERY

A recognized complication of strabismus surgery is the development of hypertrophic conjunctival scars over the operated-on muscle. Our stand ard treatment of these scars has been excision followed by corticoster oid eye drops, which results in a scar recurrence rate of 33%. Antimet abolic chemotherapeutic agents, such as mitomycin, can reduce posttrau matic scarring and vascularization of the ocular surface. We studied t he use of mitomycin eye drops as an adjunct to standard treatment of h ypertrophic conjunctival scars after strabismus surgery. Four patients were treated with adjunct mitomycin eye drops (0.2 to 0.4 mg/ml). Pos toperative follow up ranged from 16 to 56 weeks. None of these cases s howed significant scar recurrence. Mitomycin in the higher dosage caus ed mild superficial punctate keratitis after 8 days of use. Despite a lamellar sclerectomy in a patient treated with 0.2 mg/ml of mitomycin, there was no further clinically apparent loss of scleral tissue. The results of this pilot study suggest that topical mitomycin is a safe a nd effective adjunct to excision and corticosteroid eyedrops in the tr eatment of hypertrophic conjunctival scars after strabismus surgery.