丝裂霉素C联合可拆式缝线小梁切除术治疗难治性青光眼

Removable suture trabeculectomy with mitomycin C for treatment of refractory glaucoma

目的 了解可拆式缝线是否能减少丝裂霉素 C(MMC)小梁切除术后并发症。方法 MMC联合可拆式缝线小梁切除术治疗 16例 ( 2 1眼 )难治性青光眼 (RG)。术后 1天、1月及 1年 ,检查纪录术眼前房深度、眼压、滤过泡情况。结果 本组病例 ,术后早期Ⅱ度浅前房占 9.5 2 % ,持续性低眼压 14 .2 9%。术后 1年 ,保持功能性滤过泡者 76.19%。全部手术眼均无伤口漏和滤过泡漏。以眼压≤ 2 1.0 5mmHg为手术成功标准 ,手术成功率为 80 .95 %。结论 MMC可提高RG术后眼压控制率 ,而联合可拆式缝线 ,可有效控制术后滤过水平 。

Objective To determine whether the removable suture can decrease the incidence of complications after trabeculectomy with the use of mitomycin C(MMC). Methods Sixteen consecutive patients(21 eyes)with refractory glaucoma(RG)underwent removable suture trabeculectomy with MMC.The anterior chamber depth,the IOP,and the filtering bleb were examined on d 1,one month and 1 year after surgery respectively. Results The incidences of the Ⅱ degree shallow anterior chamber and postoperative hypotony were 9.25% and 14.29%,respectively.Sixteen eyes(76.19%)maintained functioning blebs during 1 year follow up period.None of 21 surgeried eyes had leaking bleb.The success rate was 80.95%(IOP≤21.05*!mmHg with or without medications). Conclusion Using MMC trabeculectomy can increase the success rate in controlling intraocular pressure in RG.Removable suture can reduce the incidence of the complications effectively after trabeculectomy with MMC.