青光眼滤过术联合应用丝裂霉素C的临床疗效

Clinical observation of glaucoma after trabeculectomy with mitomycin C

目的 探讨青光眼滤过手术联合应用丝裂霉素C (MMC)的临床疗效。 方法 将 4 2例 (5 6眼 )各种类型青光眼随机分为MMC治疗组 2 9眼和对照组 2 7眼。MMC组在小梁切除术中 ,一次将浸有 0 .2mg/ml(0 .0 2 % )的MMC棉片置于巩膜瓣下及结膜瓣下 3分钟 ,对照组不使用MMC ,术后追踪观察 5 - 2 4个月 ,平均14 .5个月。结果 MMC组的早期和晚期手术成功率分别为 93.10 %和 89.6 6 % ,对照组为 6 6 .6 7%和 5 5 .5 6 %(P <0 .0 5 ,P <0 .0 1) ;功能性滤过泡 ,MMC组 82 .76 % ,对照组 5 1.5 8% (P <0 .0 5 )。术后并发症MMC组主要为低眼压 ,但未见低眼压性黄斑病变。其它并发症有浅前房、角膜上皮损害及白内障加重 ,两组无差异。结论 青光眼滤过手术联合MMC可有效防止滤过泡瘢痕化 ,大大提高手术成功率 。

Objectives The study was designed to observe the effect of filtration surgery of glaucoma with mitomycin C(MMC).Methods 42 cases (56eyes) with all kinds of glaucoma were randomly divided into two groups , 29 eyes in MMC group and 27 eyes in control groups.Intraoperatively, 0.2mg/ml MMC for 3 minutes was used during trabeculectomy in MMC group and no MMC was used in the control group.The post-operative follow-up periods ranged from 5 to 24 months(mean, 14.5 months). Results The successful rate of the operation of MMC group in an early stage and the later stage was 93.10% and 89.66% respectively, and that of control group, 66.67% and 55.56%(P<0.05, P<0.01). The rate of eyes of functional filtering blebs in MMC group was 82.76%, and 51.58% in the control group(P<0.05).Side effect of MMC group was mainly low IOP, but no hypotonous maculopathy was found.Other complications included shallow aqueous humor, corneal epithelial injury and catract increasing, but there were no significant differences in two groups.Conclusions The results show that trabeculectomy with MMC is effect to inhibit scar formation of filtering bleb and elevate the successful rate of glaucoma filtration surgery, and it worth to be widely used.Low IOP after operation was discussed and our experiences to prevent from complication was emphasized.