非穿透性滤过手术联合丝裂霉素C治疗开角型青光眼

Non-penetrating trabecular surgerg with mitomycin C in open-angle glaucoma

目的 探讨非穿透性滤过手术联合丝裂霉素 C(MMC)的临床疗效。方法 对 15例 (2 0只眼 )开角型青光眼患者进行非穿透性滤过手术 ,术中不植植入物、应用 MMC治疗 ,术后观察视力、眼压、眼内反应、滤泡形态和前房角镜检查 ,随访 12～ 2 4月 ,平均 (15 .8± 3.5 8)月。结果 术后 1周及随访末期 2 0眼视力较术前差异无显著性。术前眼压 (34.2± 6 .5 ) mm Hg(1k Pa=1.333mm Hg) ,随访末期眼压 (16 .3± 5 .4 2 ) m m Hg,具有极显著差异 (t=9.4 5 87,P <0 .0 0 1)。术后 1只眼前房少量出血 ,2只眼轻微前房反应 ,无浅前房、炎症、脉络膜脱离等严重并发症发生。早期均可见弥散滤泡 ,随访末期 16只眼可见功能性滤泡。结论 非穿透性滤过手术联合 MMC治疗开角型青光眼降压效果好 ,安全 ,不增加患者经济负担。

Objective To study the dinic effect of NPTS with MMC. Methods 20 eyes (15 patients ) with open angle glaucoms underwent NPTS with MMC. Postoperatively, visual acuity, intraocular pressure, intraocular reactions, bleb appearance were observed, gonioscopy was performed, The follow-up period ranged from 12 to 24 months, the average was 15.8±3.58 months. Results There was not significantly difference between at the end of 1 week postoperative and follow-up and preoperative in the vision of 20 eyes. The IOP of preoperative was 34.2±6.5mmHg(1kPa=1.33mmHg). The IOP of post follow-up was 16.3±5.42 mmHg.There was greatly significant difference(t=9.4587,P<0.001). There was hemorrhage of anterior chamber in one eye and little response of anterior chamber in two eyes, there were not severity complication such as shallow anterior, chamberin, inflammation, and choroid detachment. There were diffuse blebs at the early stage of follow-up ,there were functional blebs in 16 eyes at the last stage of follow-up. Conclusions NPTS with MMC in open-angle glaucoma has good effect on reducing the IOP. It is safe, and cheap relatively.