丝裂霉素C辅助青光眼滤过手术的实验研究

Experimental study of adjunctive mitomycin C on glaucoma filtration surgery

目的 观察兔滤过手术中 1次性暴露丝裂霉素 C( mitomycin C,MMC)的疗效。方法 采用前瞻性、随机盲法对照实验。 15只白兔分为实验组 (术中用 MMC 0 .2 g·L- 1 )、空白对照组 (生理盐水 )和阳性对照组 (术后用 5 - FU) ,均行全层巩膜切除滤过术并进行观察。每组为 10眼 ,6眼临床观察眼压、滤泡形态和并发症 ,4眼于术后 2周做光镜检查。结果 MMC治疗组低眼压维持时间和滤泡持续时间均长于空白对照组。术中应用MMC比术后结膜下注射 5 - FU手术成功率明显提高 ,MMC用药组临床上未见明显毒副作用。光镜显示 MMC治疗眼可见潜在滤泡腔。结论 兔青光眼滤过术中 1次性结膜下应用 0 .2 g· L- 1

Objective To evaluate the clinic effects of a single intraoperative exposure to mitomycin C (MMC) on filtering surgery in the rabbit.Methods A prospective, randomized, masked observer, placebo controlled study was performed. Full thickness filtration surgeries were operated and data from 15 white rabbits were collected. We divided the rabbits into 3 groups, as MMC 0.2 g·L -1 , 9 g·L -1 saline solution in operation and 5 FU 50mg after operation. Each group consisted of 10 eyes, 6 eyes were for examination of intraocular pressure(IOP), bleb survival and postoperation complications, another 4 eyes for light microscopic examination. Results IOP remained lower for a longer period of time and filtration blebs lasted longer in MMC treated group than control group. Intraoperation application of MMC to the filtration site could more greatly increase surgical success than postoperative subconjunctive injections of 5 FU. No significant ocular toxicity was observed clinically in eyes treated with intraoperative administration. Light microscope showed potential bleb cavities in intraoperative 5 FU and MMC treated eyes. Conclusion A single introperative application of subconjunctive MMC 0.2 g·L -1 may be a viable method, and more greatly increase the success of glaucoma surgery in the rabbit.