丝裂霉素C结膜下注射治疗青光眼小梁切除术后功能不良滤过泡的临床观察

Clinical observation of mitomycin C subconjuctival injection on the dysfunctional filtering blebs

目的观察丝裂霉素C(MMC)结膜下注射对青光眼小梁切除术后早期功能不良的滤过泡的临床效果。方法对114例(122只眼)青光眼患者术后1～8周内滤过功能不良的滤过泡行丝裂霉素C(MMC)结膜下注射,每天结膜下注射一次,共3～7次,MMC浓度为0.004%,配合每天眼部按摩2～3次,观察滤过泡弥散隆起的情况,前房深浅的变化,随访3～6个月。结果122只眼丝裂霉素C(MMC)结膜下注射前:低平限局肥厚充血型92只眼、包囊型囊样30只眼。MMC结膜下注射后滤过泡外观形态:轻度膨隆弥散型84只眼,多腔或薄壁型24只眼,限局肥厚型或无滤过泡14只眼。结膜下注射前患眼的眼压为(28.6±2.1)mmHg,结膜下注射后患眼的眼压为(15.1±2.3)mmHg。结论对于青光眼小梁切除术后早期功能不良的滤过泡采用结膜下注射丝裂霉素C(MMC)联合眼部按摩是安全、有效及简便的处理方法。

Objective To investigate the efficacy of mitomycin C subconjucfival injection on the dysfunctional ill- tration blehs after trabeculectomies. Methods 122 eyes of 114 patients of the maLfunctional blebs with mitomycin C subconjuctival injection combined with eyeball massage 2 - 3 times everyday at clinic visits in 3 - 6 months immediately after trabeculectom ies and were followed up for 3 - 6 months. Results The blebs were diffused and elevated in 84 eyes, thinned and multicysted in 24 eyes,thickened and focalized or invisible in profile in 14 eyes . Intraocular pressures（IOPs） were significantly lowered from （ 28.6 ± 2.1 ） mmHg （ 1 mmHg = 0. 133 ） of pre-injection to （ 15.1 ± 2.3 ） mmHg of post-injection in 108 functional filtering blehs. It showed a success rate of 88.52% in the follow -up time . Conclusion Mitomycin C subconjuctival injection combined with eyeball massage is an effective, safe, and simple method of improving early dysfunctional filtration blebs after trabeculectomies.