丝裂霉素C不同放置方法对滤过手术疗效影响的研究

The study on the influence of different mitomycin C placement on the effect of filtering operation

目的 比较青光眼滤过手术中丝裂霉素 C放置在结膜瓣下与巩膜瓣下这两种不同方法的降眼压效果和合并症的发生情况 ,以便从中筛选出一种较佳的方法。方法 将 6 7只接受滤过性手术并在术中应用丝裂霉素C的原发性青光眼随机分为两组 ,A组丝裂霉素 C放置于结膜瓣下 ,B组丝裂霉素 C同时放置于巩膜面上和巩膜瓣下。二组丝裂霉素 C浓度和放置时间相同。观察二组病人手术前、后的眼压 ,视力和手术后的并发症。全部病人观察 12个月。结果 (1) A、B二组病人均有明显的降眼压效果 ;(2 ) A、B二组间的降眼压效果没有明显差异 ;(3)A、B二组病人的手术并发症没有明显差异。结论 鉴于二种不同的放置方法对滤过手术都具有相同的良好降压效果 ,且在降压作用和手术并发症的发生率方面二者却没有明显的差异 ,因此笔者认为滤过手术中丝裂霉素 C放置在结膜瓣下可能会减少它对眼内的穿透力 。

Objective Compare the effect of lowering intraocular pressure (IOP) and complications of subconjunctival micomycin C placement with those of subscleral mitomycin C(MMC) placement and select a prefer method.Methods Sixty seven eyes suffered from primary glaucoma who underwent filtering operation and were applied MMC during operation were divided into two groups randomly.In group A MMC was placed subconjunctivally,but in group B MMC was placed subsclerally.The concentration and applying time of MMC in the two groups are similar.The visual acuity and IOP before and after sugery,complications after surgery were observed for 12 months.Results: (1)There was significant effect of lowering IOP both in group A and group B.(2)The effect of lowering IOP had no significant difference between group A and group B.(3)Operating complications of the two groups have no significant difference.Conclusions Considering the two methods of MMC placement have similar good effect of lowering IOP and have no significant difference in lowering IOP and the incidence of complications,we think the way that MMC was placed subconjunctivally can decrease its penetrating into the eye and the toxicity of MMC on the ocular tissue.