Semiconductor diode laser transscleral cyclophotocoagulation versus filtering surgery with Mitomycin-C

Both filtering surgery with Mitomycin-C and diode laser cyclophotocoagulation have proved to be effective alternatives in cases of glaucoma with poor surgical prognosis. The right eyes of 40 pigmented rabbits were randomly divided into 2 groups: Mitomycin-C group underwent filtering surgery with application of 0.4 mg/ml of Mitomycin-C whereas the diode laser (DL) group received 15 applications of 1.8 J (1800 mW. 1000 ms) distributed in 270°. Mean IOP showed statistical differences in two periods between days 3–13 and 45–60 — Mann-Whitney U test — with a higher IOP lowering in the DL group. The comparison of IOP survival curves (Log-Rank test) was not significant p = 0.070809. Ocular hypertension, hyphema and inflammatory signs were higher in the DL group, both in short and long term, but in terms of statistical significance only ocular hypertension showed differences p = 0.00011717 - Fisher exact test. Microscopic examination revealed patent sclerostomies in 60% of the MMC group eyes with different grades of fibroblastic proliferation. In the DL group we observed necrosis of the sclieral stroma and of the pigmented and unpigmented ciliary epithelium, with signs of thermal coagulation of the ciliary stroma and of the stromal vasculature. We must point out that the treatment with laser has proved to be more effective although both treatments showed very acceptable IOP lowering until 2 months after the surgery.     

翼状胬肉不同术式效果观察

目的寻求一种理想的手术方法以减少胬肉术后的复发率。方法对636例726眼采用单纯胬肉切除术(209眼)。带蒂结膜瓣转移术(158眼)，保存羊膜移植术(94眼)，丝裂霉素C应用加带蒂结膜瓣转移术(131眼)，自体角膜缘干细胞移植术(134眼)等方法治疗，随访6月至7年，比较其复发率。结果术后复发率，单纯胬肉切除为29．67％，带蒂结膜瓣转移术为20．25％，保存羊膜移植术为15．96％，丝裂霉素C应用加带蒂结膜瓣转移术为6．11％，自体角膜缘干细胞移植术为3．73％。结论自体角膜缘干细胞移植术和丝裂霉素C应用加带蒂结膜瓣转移术减低了胬肉的复发率。取得了良好的效果，是二种理想的手术方法。值得推广。     

丝裂霉素C与青光眼滤过泡并发症的相关关系

目的分析小梁切除术中应用丝裂霉素C(mitomycin-C,MMC)与青光眼滤过泡相关并发症的关系。方法对31例36只眼在小梁切除术中应用了MMC而导致的滤过泡相关并发症的患眼进行临床分析,分析其滤过泡形态、眼压、视力的改变和黄斑水肿的发生及与术中MMC的浓度、放置时间、放置部位之间的关系。结果31例36只眼中发生滤过泡渗漏11只眼、滤过泡感染1只眼、巨大薄壁滤过泡7只眼、单纯薄壁滤过泡7只眼、低眼压合并黄斑囊样水肿10眼;并发症的发生时间平均(1724±2000)m;平均视力下降2行以上;并发症的发生与MMC放置的位置显著相关,与时间呈正相关,与浓度无关;眼压下降与MMC浓度呈负相关。结论小梁切除术后滤过泡并发症的发生与MMC的应用密切相关,结膜瓣下与巩膜瓣下同时放置、放置时间长者比较容易发生并发症;高浓度者容易造成低眼压。     

丝裂霉素C联合巩膜瓣可移动缝线治疗原发性青光眼的临床效果

目的：探讨丝裂霉素C联合巩膜瓣可移动缝线治疗原发性青光眼的临床效果。方法按照手术方式不同将本院收治的120例原发性青光眼患者分为常规组40例、丝裂霉素C组40例和缝线组40例,常规组给予常规小梁切除术治疗,丝裂霉素C组术中应用丝裂霉素C的小梁切除术治疗,缝线组术中联合使用丝裂霉素C＋巩膜瓣可移动缝线小梁切除术治疗,比较3组患者术前、术后第3天、术后1周、术后1个月、术后3个月和术后6个月的眼压变化,术后半年滤过泡情况、术后早期前房深度以及并发症发生情况。结果3组患者术后眼压均显著下降,与术前比较,差异有统计学意义（P〈0.05）;丝裂霉素C组和缝线组患者术后不同时间眼压均显著低于常规组,差异有统计学意义（P〈0.05）;丝裂霉素C组和缝线组患者功能性滤泡形成率均显著高于常规组,差异有统计学意义（P〈0.05）;丝裂霉素C组患者术后早期Ⅰ、Ⅱ度浅前房发生率均显著高于常规组,差异有统计学意义（P〈0.05）;缝线组患者术后早期Ⅰ、Ⅱ度浅前房发生率均显著低于丝裂霉素C组,差异有统计学意义（P〈0.05）;3组均未出现角膜损伤、结膜瓣漏、黄斑水肿、眼内炎、恶性青光眼等并发症。丝裂霉素C组患者正常前房率显著低于常规组和缝线组,差异有统计学意义（P〈0.05）。结论原发性青光眼术中丝裂霉素C联合巩膜瓣可移动缝线能显著提高手术的成功率,改善眼压,合理控制缝线的拆除数目及时间,临床应用和推广价值较高。     

减少翼状胬肉复发的三种术式疗效比较

目的 比较丝裂霉素C应用加带蒂结膜瓣转移术;羊膜移植术、自体带结膜瓣的角膜缘干细胞移植术治疗初发翼状胬肉的临床疗效,寻求一种理想的手术方法.方法 将95例(110眼)患者随机分为三组,分别采用丝裂霉素C应用加带蒂结膜瓣转移术(MMC组,34眼)、羊膜移植术(AMT组,37眼)和自体带结膜瓣的角膜缘干细胞移植术(ALCT组,39眼),术后随访一年,比较创面修复时间及复发率.结果 ALCT组1眼复发,复发率为2.56%,AMT组3眼复发,复发率为8.11%,两组比较差异无统计学意义(P＞0.05),MMC组9眼复发,复发率为26.47%,与其它两组比较差异有统计学意义(P＜0.05).角膜创面上皮平均修复时间ALCT组为(4.73±1.15)d,AMT组(6.36±1.35)d,MMC组为(8.56±1.15)d,三组比较差异有统计学意义(P＜0.05).结论 自体带结膜瓣的角膜缘干细胞移植术治疗初发性翼状胬肉术后复发率低,角膜创面修复快,是一种理想的手术方法.     

Haemolytic uraemic syndrome in a patient with lung cancer: Further evidence for a toxic interaction between Mitomycin-C and tamoxifen

We present the case history of a patient with lung cancer who developed the haemolytic uraemic syndrome following combination chemotherapy containing Mitocmycin-C and tamoxifen.     

生物反应调节剂（BRM－102）冲剂诱变和抗诱变作用的研究

采用微核法对生物反应调节剂冲剂（ＢＲＭ－１０２）的诱变和抑制诱变作用进行了研究。结果显示ＢＲＭ－１０２提取液各种浓度组与阴性对照组统计学处理无意义，表明该冲剂尚未有诱发正常人淋巴细胞微核率升高的作用，不致引起体细胞遗传损伤；对诱变剂丝裂霉素Ｃ诱发正常人淋已细胞微核率有明显的抑制作用。     

Role of Mitomycin-C in Prevention of Post Operative Adhesions After Endoscopic Sinus Surgery––A Prospective Study

To evaluate the role of Mitomycin-C in preventing synaechiae formation and ostial stenosis following endoscopic sinus surgery. This prospective study was conducted in VMMC and Safdarjung hospital from November 2007 to August 2008. 30 subjects aged between 16 and 60 of either sex in two groups were included in the study. All these patients with bilateral nasal polyposis underwent endoscopic sinus surgery with topical application of Mitomycin-C and were subjectively and objectively assessed for improvement of symptoms and post operative synaechiae formation. Patients showed improvement in subjective symptoms mainly nasal obstruction and hyposmia as well as decreased incidence of synaechiae formation and ostial stenosis post surgery following Mitomycin-C application. After doing this study we could conclude that Mitomycin–C applied topically following endoscopic sinus surgery was helpful in improvement of symptoms like nasal obstruction and hyposmia as well as decreased adhesion rate and middle meatal antrostomy closure rate. Topical application of Motomycin-C was safe in a dose of 0.4–0.8 mg/ml applied over 5 min and offered significant improvement both subjectively and objectively.