滤过手术中丝裂霉素C不同用法的疗效分析

目的 比较青光眼滤过手术中丝裂霉素C（MMC）结膜瓣下与巩膜瓣下两种应用方法的降压效果和并发症的发生情况。方法 132眼接受滤过手术的原发性青光眼随机分为对照组和MMC组，再将应用MMC（0．4mg／ml，3min）的66眼分成结膜瓣下（MMC-A）组和巩膜瓣下（MMC-B）组。观察1年内3组患者手术后的眼压、视力和手术并发症。结果 MMC组与对照组相比眼压下降差异有统计学意义（P〈0．05），功能性滤过泡形成率71．21％，手术成功率达75．76％，而两组手术并发症无显著性差异。MMC两组病人的降压效果和并发症的差异无统计学意义。结论 MMC作为滤过性手术辅助药物，可增加手术成功率，而且无严重并发症。MMC放置在结膜瓣下和巩膜瓣下效果相似，但放置在结膜瓣下可能会减少对眼内组织的毒性。

Application of mitomycin C with different methods in filtering surgery

Objective To investigate the clinical effect of filtering surgery with application of mitomycin C by different methods. Methods 132 eyes of primary glaucoma were divided into MMC group and control group.66 eyes applied MMC(0.4 mg/ml,3 min),the group MMC-A applied MMC subconjunctivally and the group MMC-B applied MMC subsclerally.The visual acuity,IOP and complication had been followed up for one year. Results There were significant difference between MMC group and control group on lowering IOP(P<0.05),the rate of functional bulb was 71.21%,the success rate was 75.76% in MMC group.The surgical complications have no significant difference between two methods.The effect of lowering IOP and the incidence of complications had no significant difference between MMC-A group and MMC-B group.Conclusions MMC can increase the success rate of filtering surgery.The treatment effects of MMC placed subconjunctivally is similar to MMC placed subsclerally,but MMC placed subconjunctivally may be will decrease the toxicity of MMC on intraocular tissues.