非穿透小梁手术中应用丝裂霉素C的疗效

Non-penetrating trabecular surgery with application of mitomycin C

目的 评价非穿透小梁手术中应用丝裂霉素C治疗原发性开角型青光眼的临床疗效。方法 对 18例 (2 5只眼 )原发性开角型青光眼患者行非穿透小梁手术 ,术中联合应用丝裂霉素C。术后随访 6～ 2 8个月 ,平均 16个月。结果 患者术前平均眼压 (2 7 93± 7 6 2 )mmHg(1mmHg =0 133kPa) ;术后 3个月 ,平均眼压降至 (14 6 2± 3 5 3)mmHg ;差异有显著意义 (t=11 82 ,P <0 0 0 1)。术后2 5只眼均形成明显的弥散滤过泡。术后 3个月 ,2 1只眼有功能性滤过泡 ,4只眼功能性滤过泡消失。术后前房反应轻 ,1只眼发生前房出血 ;4只眼术中发现小梁网处有小穿孔 ,但无虹膜膨出 ,术后前房角镜检查均可见小穿孔 ;2只眼术中未发现小穿孔 ,而前房角镜下观察有小裂隙。结论 非穿透小梁手术中应用丝裂霉素C ,能有效降低开角型青光眼的眼压。术后患者视力恢复快 ,并发症少而轻。

Objective To evaluate the clinical effect of non penetrating trabecular surgery (NPTS) with mitomycin C (MMC) in primary open angle glaucoma (POAG) Methods Twenty five eyes of 18 patients with POAG underwent NPTS with MMC during the operation The mean follow up was 16 6 months (6 28 months) Results The mean preoperative intraocular pressure (IOP) was (27 93±7 62) mm Hg (1 mm Hg =0 133 kPa) which decreased to a mean postoperative IOP of (14 62±3 53) mm Hg ( P <0 001) After operation, there was an obvious diffuse bleb in each eye, in the 3 months after operation, there were functional blebs in 21 eyes, and the successful filtration was ceased in 4 eyes The anterior chamber reaction was mild Hyphema occurred in 1 eye after operation Intra operatively, in 4 eyes microperforations occurred in the trabecular meshwork without iris prolapse, and after operation, under the gonioscope, the perforation could be observed in these eyes In another 2 eyes, there was no intra operative perforation, but a small fissure was seen by gonioscopy Conclusions NPTS with application of MMC can lower the IOP effectively in this group of patients The recovery of vision after operation is quick A few complications occurred after operation It is a promising technique to treat POAG