球结膜下注射5-FU治疗早期功能不良滤过泡的临床观察

Clinical Observation of Ball Subconjunctival Injection of 5-FU in Treatment of Early Dysfunctional Filtering Bleb

目的探讨球结膜下注射5-FU治疗青光眼小梁切除术后早期功能不良的滤过泡处理效果。方法将40例（40只眼）行小梁切除术后早期功能不良滤过泡的患者随机分为两组各20只眼。对照组均进行针拨分离和眼球按摩治疗,治疗组在此基础上给予5-FU 0.3 m L结膜下注射。所有患者随访1～6个月,比较两组的临床疗效、平均眼压和并发症发生情况。结果治疗组19只眼形成功能性滤过泡,成功率为95.0%,对照组13只眼形成功能性滤过泡,成功率为65.0%,两组比较差异显著（P〈0.05）。两组治疗后平均眼压均显著改善,且治疗组改善程度显著优于对照组,差异具有统计学意义（P〈0.05）。结论治疗早期功能不良的滤过泡行针拨分离联合球结膜下注射5-FU及眼球按摩是操作简单、有效、并发症少的治疗方法。

Objective To discuss the effect of ball subconjunctival injection of 5-FU in treating early dysfunctional filtering bleb after glaucoma trabeculectomy. Methods 40 cases（40 eyes） of patients with early dysfunctional filtering bleb after glaucoma trabeculectomy were randomly divided into two groups. The control group（20 eyes） was given needle revision separation and eyeball massage for treating,the treatment group（20 eyes） was given subconjunctival injection of 5-FU（0.3 m L）. All patients were followed up for 1 ～ 6 months, and the clinical effects, average intraocular pressure and complications were compared between two groups. Results 19 eyes in treatment group developed into functional filtering bleb, with the success rate being 95.0%; 13 eyes in control group developed into functional filtering bleb,with the success rate being 65.0%; the difference of two groups was statistical（P〈0.05）. The average intraocular pressure of two groups after treatment were significantly improved, and the improvement degree of treatment group was better than that of control group, with statistical difference（P〈0.05）. Conclusions For patients with dysfunctional filtration bleb, needle revision separation combines with subconjunctival injection of 5-FU and eyeball massage is an effective treatment method with easy operation and less complication.