Related Experiment Videos
Long-term results using adjunctive mitomycin C in optic nerve sheath decompression for pseudotumor cerebri
T C Spoor1, J G McHenry, D H Shin
1Kresge Eye Institute, Wayne State University, Detroit, MI 48201-1423, USA.
Ophthalmology
|December 1, 1995
Summary
Mitomycin C pretreatment during optic nerve sheath decompression (ONSD) reduces scarring, improving long-term visual outcomes in pseudotumor cerebri patients. Repeat surgeries are also made easier and more successful.
Area of Science:
- Ophthalmology
- Neurosurgery
Background:
- Optic nerve sheath decompression (ONSD) is performed for pseudotumor cerebri, but some patients experience later visual deterioration.
- Repeat ONSD can restore vision but is challenging due to scar tissue formation.
Purpose of the Study:
- To evaluate the long-term efficacy of ONSD when optic nerve sheaths are pretreated with mitomycin C.
- To assess if mitomycin C reduces scarring and improves outcomes in repeat ONSD procedures.
Main Methods:
- A transconjunctival medial orbitotomy approach was used to expose optic nerve sheaths.
- Optic nerve sheaths were treated with mitomycin C (0.5 mg/ml) for 5 minutes before incision.
Main Results:
- Repeat ONSD with mitomycin C resulted in stable visual function for over 3 years in two patients.
- Primary ONSD showed initial visual field improvement in four eyes; three with cysts/fistulas remained stable.
- One eye with declining vision improved after repeat ONSD, showing no orbital scarring and successful lysis of adhesions.
Conclusions:
- Mitomycin C is a safe adjunct to ONSD, with patients followed for 20-37 months.
- Fistulization and cyst formation correlate with better visual function; their closure may worsen vision due to adhesions.
- Adjunctive mitomycin C reduces orbital scarring, facilitating easier and more successful repeat surgeries.