Serial sub-conjunctival 5-Fluorouracil for early recurrent anophthalmic contracted socket

Abstract

Weekly injections of 5-FU are effective for stopping the progression of recurrent contracted socket following primary reconstructive surgery. It provides early rehabilitation, and avoids repetitive surgery.

Revisiting the Role of the Myofibroblast in Socket Surgery: An Immunohistochemical Study

“…Because the authors did not report any toxic side effects from any of the agents used in the study, it could be easily argued that the adjunctive use of antimetabolites or anti-inflammatory agents in severe anophthalmic socket reconstruction is an effective option to control the scarring response, and could be effortlessly tolerated without side effects. The authors could also make unsubstantiated claims that this study lends further laboratory support to the aforementioned clinical studies 9 , 10 thus confirming the beneficial role of antimetabolites as an adjunct in contracted socket repair; however, this study has several inherent limitations that must be scrutinized in detail first.…”

“…In 1987, Kaltreider et al 7 were the first to demonstrate that the myofibroblast could be implicated as the cell responsible for contraction in the anophthalmic socket, but unfortunately since their original publication almost 30 years ago this harmful role has received little attention. It seems only sensible that the next step would have been to identify chemical agents that could help keep this cell in check, and although over the past several years the intraoperative or postoperative use of MMC or 5-FU as an adjunct drug during contracted socket surgery has shown some success in clinical studies; 9 , 10 to the best of the authors knowledge, no experimental studies corroborated these findings. Until newer medications that would help fight the action of myofibroblasts are commercially available, the authors sought to identify the most effective commercially available wound modifying agent that would help keep this unusual cell in check.…”

Evaluation of Topical Mitomycin-C Eye Drops After Reconstructive Surgery for Anophthalmic Contracted Socket

“…In the current study, we did not report any complications related to the usage of topical anti-metabolite therapy (such as allergic reaction, tissue necrosis or wound dehiscence) through the whole follow up period, which is comparable to the results of the studies conducted by Priel et al and Kamal et al 19,21 The main limitations of this study are its retrospective design, small sample size and relatively short follow-up period. Further prospective studies using larger samples would support our results.…”

“…15,16 Even after careful planning and meticulous surgery, the repeated contraction of socket commonly occurs, causing 17,18 Postoperative use of antimetabolites was also evaluated by other studies that focused on the injection of antimetabolites into the reconstructed conjunctival tissue, they are most useful when used in the early postoperative period, namely the first 4 postoperative weeks, when maximum healing and contraction occur. [19][20][21] To the best of our knowledge, this is the first study that reports the results of postoperative use of topical antimetabolites (MMC eye drops) following socket reconstructive surgeries.…”

“…In addition, it is a relatively safe and effective line of treatment in surgeries for pterygium, ocular surface neoplasia and nasolacrimal duct obstruction. [9][10][11][12] Previous studies found that the intraoperative and postoperative injection of antimetabolites (MMC and 5-Fluorouracil [5FU]) is effective for the treatment of contracted socket. 9,10 The aim of this retrospective study is to report the outcomes of using topical MMC eye drops after reconstructive surgery for contracted socket, and to compare the results with those of the conventional postoperative topical treatment.…”