抗青光眼滤过术中应用5-氟尿嘧啶和丝裂霉素C对泪膜的影响

目的　观察抗青光眼滤过术中应用5-氟尿嘧啶（5-fluourouracil,5-Fu）和丝裂霉素C（mitomycinC,MMC）对泪膜的影响。方法　回顾性分析难治性青光眼71例,其中使用5-Fu组24例（24只眼）,MMC组17例（17只眼）,对照组（未用药）30例（30只眼）,观察指标包括眼部异物感、干涩、畏光、痒感、结膜充血、分泌物、角膜荧光素染色及结膜、角膜虎红染色、泪膜破裂时间、Schirmer试验及眼压测量值。结果　5-Fu组患者的眼部症状和体征明显,泪膜功能受损,与对照组比较差异有显著性（P<0.05）,MMC组患者眼部干涩症状明显（P<0.05）,而其他观察指标与对照组相比差异无显著性。结论　抗青光眼滤过术后应用5-Fu可明显损害泪膜的功能。

Influence on tear film of postoperative 5-fluourouracil and intraoperative mitomycin C in glaucoma filtration surgery

OBJECTIVE: To investigate the changes of tear film functions due to the use of postoperative 5-fluourouracil (5-Fu) and intraoperative mitomycin C (MMC) in glaucoma filtration surgery. METHODS: 71 eyes of 71 refractory glaucoma patients were followed up after filtration surgery. They were divided into 3 groups. The 5-Fu and MMC groups consisted of 24 and 17 eyes respectively. The other 30 eyes that underwent the surgery without any use of antimetabolic agents were in the control group. The observed symptoms included ocular foreign body sensation, dryness, photophobia, itching and discharge. The available criteria were conjunctival congestion, fluorescein and rose bengal staining on the cornea and conjunctiva, break-up time of tear film and Schirmer's test. RESULTS: The ocular symptoms and signs were manifest and tear film functions were significantly decreased in 5-Fu group (P < 0.05). No significant difference between MMC and the control was seen, except that the dry feeling was significantly intensive in MMC group (P < 0.05). CONCLUSION: The postoperative use of 5-Fu after glaucoma filtration surgery leads to tear film abnormalities apparently.