摘要
目的 探讨青光眼复合小梁切除术中个性化使用丝裂霉素(MMC)的疗效和并发症.方法 对我院原发性开角型青光眼的复合小梁切除术的48例(76眼)进行回顾性分析.76眼均行复合小梁切除术,术中使用MMC的浓度为0.3 mg/ml,放置MMC棉片时间为2~5 min.放置MMC时间主要根据患者年龄、眼球筋膜的厚度及术后目标眼压而定.手术成功率的3个标准是:(1)眼压≤18 mmHg(1 mmHg =0.133 kPa)和眼压降低20%;(2)眼压≤15 mmHg和眼压降低25%;(3)眼压≤12 mmHg和眼压降低30%.术后观察指标:手术成功率、视功能、渡过泡及并发症.随访12~36个月,平均(21.50 ±2.67)月.结果 术前平均眼压(31.28±7.67) mmHg,术后12个月平均眼压(13.28±3.87) mmHg,两者比较差异有统计学意义(t=4.162,P=0.000).按手术成功率3个标准,术后12个月成功率分别为95.79%,86.32%,和71.12%;76眼均为功能滤过泡,其中Ⅰ型32眼、Ⅱ型44眼.7眼(9.21%)术后局部需用1种降眼压药才能控制眼压.术后并发症:8眼(10.53%)术后早期浅前房,未见其他严重并发症.结论 青光眼复合小梁切除术中个性化使用MMC能有效降低原发性开角型青光眼的眼压,并发症少.
Objective To evaluate the efficacy and complications of trabeculectomy with individual application of mitomycin C (MMC) for primary open-angle glaucoma.Methods The data of 76 eyes of 48 patients with primary open-angle glaucoma who underwent trabeculectomy with individual application of MMC were reviewed.All patients underwent trabeculectomy with application of 0.3 mg/ml MMC for 2 ~ 5 min which accorded to the age,Tenon' s capsule thickness and postoperative target intraocular pressure(IOP).Success rates were defined according to three criteria:(1) IOP ≤ 18 mmHg (1 mmHg =0.133 kPa) and IOP reduction ≥ 20%;(2) IOP ≤15 mmHg and IOP reduction≥25%;and (3) IOP≤12 mmHg and IOP reduction≥30%.The success rate,visual acuity,type of filtering blebs and complications after the surgery were observed.The follow-up duration was 12 ~36 months with average (21.50 ± 2.67) months.Results Mean IOP decreased from (31.28 ± 7.67) mmHg before surgery to (13.28 ± 3.87) mmHg 1 year after the surgery (t =4.162,P =0.000).The success rates were 95.79%,86.32% and 71.12% at 1 year after the surgery for the three criteria respectively.Type Ⅰ filtering blebs were observed in 32 eyes,and type Ⅱ in other 44 eyes.Seven eyes (9.21%) required one kind of antiglaucoma medications to control IOP.There were 8 eyes (10.53%) with shallow anterior chamber in the early stage after the surgery.No other complication were noted.Conclusion Trabeculectomy with individual application of MMC can effectively reduce IOP in open-angle glaucoma with few complications.
出处
《中华眼外伤职业眼病杂志》
2015年第5期369-371,共3页
Chinese Journal of Ocular Trauma and Occupational Eye Disease