Mitomycin-C Improves Amniotic Membrane Graft Outcomes for Socket Reconstruction

Topical mitomycin-C (MMC) treatment following reconstructive socket surgery is associated with increased forniceal depth and socket volume (SV), according to results of a retrospective study, published in Clinical Ophthalmology.

An investigative team reviewed medical records between 2018 and 2020. They assessed patients (N=30) who underwent reconstructive anophthalmic socket surgery for clinical outcomes on the basis of conventional treatment with antibiotics and steroids (n=15) or topical 0.02% MMC eye drops administered 4 times daily for 6 weeks (n=15). In addition, the study reviews 2 specific cases.

The MMC and control cohorts were aged mean 49.15 (range, 34-57, 53.3% men) and 50.1 (range, 35-59, 60% men) years, respectively, and 33.3% in each group had an ocular malignancy, 26.7% and 20% an ocular trauma, 40% and 46.7% a blind painful eye, and the number of prior surgeries was 2.1 (range, 0-4) and 1.89 (range, 0-3), respectively.

Mean preoperative inferior fornix depth (IFD) was 1.67±0.04 mm among the MMC and 1.58±0.37 mm for controls. At 6 months, IFD was increased among MMC recipients (mean, 6.1±0.27 vs 5.12±0.25 mm; P <.01). Superior fornix depth increased from 8.3 to 13.4 mm among the MMC and 8.9 to 10.2 mm among controls (P =.01).

SV increased from 0.75±0.1 and 0.80±0.12 mL to 1.9±0.2 and 1.3±0.09 mL (P =.01) among the MMC and control cohorts, respectively.

For the MMC recipients and controls, the operation was determined to be successful (87% vs 60%), acceptable (6.5% vs 13.5%), and poor (26.5% vs 26.5%), respectively.

A 53-year-old woman with a history of evisceration due to endophthalmitis received a secondary ball implantation with adequate prosthesis but had recurrent socket infections resulting in grade 2 socket retraction. Reconstruction with amniotic membrane graft (AMG) was performed. The patient received conventional postoperative antibiotic-steroid combination and the final prosthesis fitting was acceptable.

A 44-year-old man with a history of evisceration due to traumatic endophthalmitis received a secondary ball implantation and developed a grade 2 contracted socket due to inappropriate wearing of the prosthesis. Reconstruction with AMG was performed. The patient received topical MMC and the final prosthesis fitting was successful.

This study was limited by the small sample size and short study duration.

This retrospective review found evidence to support using topical MMC following reconstructive socket surgery, as it was associated with higher forniceal depth and greater SV than conventional therapy.

Reference

Mattout HK, Fouda SM, Al-Nashar HY. Evaluation of Topical Mitomycin-C Eye Drops After Reconstructive Surgery for Anophthalmic Contracted Socket. Clin Ophthalmol. 2021;15:4621-4627. doi:10.2147/OPTH.S343550