丝裂霉素C对青光眼小梁切除术后眼内压和眼血流的影响

Influence of mitomycin C to intraocular pressure and blood flow of glaucoma patients after trabeculectomy

目的：分析丝裂霉素C对青光眼小梁切除术后眼内压和眼血流的影响,探讨其有效性和安全性。方法：将103例青光眼患者随机分为两组,均给予青光眼小梁切除术,观察组在术中行丝裂霉素C抗瘢痕治疗;术后完成6-12mo随访,对比两组患者的临床眼压控制疗效、并发症发生率及视网膜中央动脉血流动力学指标。结果：观察组临床疗效优于对照组（P〈0.05）;两组患者的总并发症发生率无统计学差异（P〉0.05）,但并发症类型有所区别,观察组多发生低眼压和畏光症状,对照组多发生瘢痕性阻塞。治疗前,两组患者的眼压动力学指标无统计学差异（P〉0.05）;治疗后1mo,观察组收缩期峰速（peak systolic velocity,PSV）与舒张末期血流速度（enddiastolic velocity,EDV）明显低于对照组,阻力指数（resistance index,RI）与搏动指数（pulsatility index,PI）明显高于对照组,差异有统计学意义（P〈0.05）;治疗后6mo,观察组PSV与EDV明显高于对照组,RI与PI明显低于对照组,差异有统计学意义（P〈0.05）。结论：丝裂霉素C对青光眼小梁切除术患者的术后不良影响时间较短,其长期疗效安全、可靠。

AIM ： To explore the efficacy and safety of mitomycin C used in trabeculectomy by analyzing intraocular pressure and blood flow.METHODS： A total of 103 patients with glaucoma were divided into 2 groups randomly,and all patients were treated with trabeculectomy, while patients in the observation group were given mitomycin C extra. At 6 -12mo follow-up were com pleted after operation,and the clinical efficacy, complications and hemodynamic characteristics of central retinal artery w ere compared between groups.RESULTS： The clinical efficacy of the observation group was higher than that of the controls（ P〈0. 05）.There was no significant difference in complication rate between groups（ P〉0. 05）,but the complication type was differentiate to some extent. Low intraocular pressure and photophobia symptoms occurred mostly in the observation group, while cicatricial obstruction occurred mostly in the controls. Before treatment,there was no significant difference in hemodynamic characteristics between groups（ P〉0. 05）. One month after treatm ent,the peak systolic velocity（ PSV） and end diastolic velocity（ EDV） of the observation group ere obviously lower, while resistance index（ RI） and pulsatility index（ PI） were higher than those of the controls,the difference was statistically significant（ P〈0. 05）. Six months after treatment,the PSV and EDV of the observation group w ere obviously higher,while RI and PI were lower than those of the controls, the difference was statistically significant（ P0. 05）.CONCLUSION： Mitomycin Chas a short-term harmful effect on glaucoma patients after trabeculectomy,but its long-term effect is safe and reliable.