小梁切除联合MMC治疗青光眼的临床观察

Clinical observation of trabeculectomy with mitomycin C for the treatment of glaucoma

目的探讨小梁切除联合丝裂霉素C治疗青光眼的临床疗效。方法应用小梁切除术联合丝裂霉素C治疗32例(45眼)各型青光眼,术中一次性使用0.2mg/ml丝裂霉素C,术后随访6-24月,观察其临床疗效及其并发症。结果术后1月检查,33眼(73.33%)术后视力有不同程度的提高;术后1周测眼压,平均11.20±2.15mmHg,术后6月测眼压,平均16.86mm±3.81mmHg,均较术前有统计学差异;末次随访时,41眼(91.1%)形成弥散扁平的功能性滤过泡;总手术成功41眼(91.1%)。术后主要并发症为:浅前房2眼,前房积血1眼,角膜水肿3眼。讨论小梁切除联合丝裂霉素C治疗青光眼,可有效地减少青光眼术后滤过道瘢痕的形成,充分降低眼压。该方法不需要特殊设备,并发症少,手术效果好,是一种安全、有效的治疗青光眼方法。

Objective To explore the clinical efficiency of trabeculectomy with mitomycin C （MMC） on glaucoma. Methods A total of 32 cases（45eyes） of glaucoma received the reformed trabeculectomy,0.2mg/ml MMC was used in the operation. The clinical efficiency and complication was observed. The post-operative follow-up periods ranged from 6 to 24 month. Result At 1 month postoperatively ,the visual acuity of 33 eye （73.33%） increased in different levels. At postoperative lweek and 6 months, the intraocular pressure were（11.20 ± 2.15）mmHg and （16.86 ± 3.81）mmHg respectively; Compared with preoperative intraocular pressure（40.33 ± 13.35）mmHg, there was significant difference （ both P 〈 0.01）. At last follow-up ,there were diffused and flat functional blebs in 41 eyes（91.11%） and non-fimctional blebs in 4 eyes（8.88%）. 41 eyes （91.11%）had suecessfid operations. The postoperative complications were shallow anterior chamber（2 eyes）, hyphema （1 eye）and c.orneal edema（3 eyes） .Conclusion Trabeculeetomy with mitomycin C for glaucoma can effectively reduce postoperative scar adhesion of the filtration passage and lower the IOP to a target level. It is sate and effective treatment for glaucoma, which needs no special equipments and with fewer complications.