抗腫瘤性藥物對手術後翼狀贅片再發之抑制效果

The Inhibitory Effect of the Anti-Tumor Drugs on the Recurrence of Postoperative Pterygium

陳德照(Te-Tsaw Chen) ； 侯平康(Pin-Kan Hou)

《中華民國眼科醫學會會刊》 3卷 (1964/05) Pp. 54-61

https://doi.org/10.30048/ACTASOS.196405.0008

並列摘要

1. Anti-tumor drugs were used after the extirpation of pterygium, and their inhibitory effects on the recurrence of pterygium were observed. In our series, Tespamin (Thio TEPA) solution was instilled in 15 cases 17 eyes, and Mitomycin, C solution in 6 cases 6 eyes.
2. Three operation methods were performed, i.e. Mon's bare sclera method, simple extirpation, and modified Mc Reynold's mothod. Bare sclera was left in different size with or without limbal groove added. The operation method seemed to affect the recurrence rate of the pterygium less but more on the cosmetic appearance of the conjunctiva.
3. Tespamin solution was made by dissolving in normal saline to make 0.5mg/ml, 1.0mg/ml or occasionally 4.0mg/ml. solution. Mitomycin C. solution was made by dissolving in 5% glucose solution to make the concentration of 0.4mg/ml. Both Tespamin & Mitomycin C solutions were instilled 4 times daily for about 2 weeks. In some series, steroid hormone instillations were used for reducing the irritative and inflammatory action, and sulfazine eye drops were used in all cases for preventing the secondary infection.
4. The local instillation of the two anti-tumor drugs, especially Mitomycin C solution, caused some irritation of the eye. Epiphora, photophobia and redness of eyes were the usual complaint, but no systemic side effect was found in all cases.
5. The combination of steroid hormone with the anti-tumor drugs might reduce the local irritative and inflammatory reaction and let the patients feel better. But its usage after the with-drawal of the anti-tumor drugs might cause the rapid repair of the defect with remaining conjunctival tissue, and increase in the recurrence rate of post-operative pterygium.
6. Variable size of granuloma, usually one in number, frequently appeared on the growing end of the resected conjunctiva, shortly after the withdrawal of the anti- tumor drug instillation, but rapidly disappeared on the continuation of their usage.
7. Favorable results were obtained by using the anti-tumor drugs. In our series, only 2 eyes were found to have recurrence during 2 to 8 months' observation period. In regard to the low recurrent rate, selection of cases and short observation period might be a related factor.
8. The introduction of the anti-tumor drugs into the Ophthalmological field is so short in time that it is just in a newly developing stage. It is necessary to study further in regard to their preparation for instillation and their usage Further close observation and analysis on their late side effects on ocular tissues are also quite valuable.