抗青光眼滤过手术中抗代谢药物促滤泡形成的临床研究

目的 :探讨青光眼滤过手术中抗代谢药物促滤泡形成的作用。方法 :对 45 0例难治性青光眼患者实施小梁切除术 ,手术分为 3组 ,A组采用无暴露线结的巩膜瓣缝线可拆除技术 ,并在术中使用沾有 0 5mg/ml的丝裂霉素C(MMC)液棉片处理巩膜切口 ,B组和C组实施常规小梁切除术 ,术后B组结膜下注射 5 Fu ,C组不用抗代谢药物 ,仅做常规处理。结果 :术后 3 88只眼随访 6～ 3 0个月 ,A组的成功率从 86%降至 65 % ,B组从 83 %降至60 % ,C组 6～ 2 4个月的成功率从 5 8%降至 2 6% ,明显低于使用抗代谢药物组 (P <0 .0 5 ) ,A组的术后并发症较B组少。结论 :抗代谢药物 5 Fu和MMC均能明显抑制滤过区瘢痕形成 ,提高难治性青光眼的手术成功率 ,MMC的效果较 5 Fu更好 ,并发症也较少

Clinical study of promoting filtration bleb with antimetabolites on glaucoma filtering surgery

Objective: To explore the effect of promoting filtration bleb with antimetabolites on glaucoma filtering surgery.Methods: 450 eyes with refractory glaucoma were divided three groups and performed trabeculectomy.In the group A,0.5 mg/ml of MMC was used in the trabeculectomy in which a technique of removable and non exposure knot sutuer was applied.In the group B and the group C,a standard trabeculectomy was performed.5 Fu was injected into conjunctiva in the group B and no any antimetabolites was used in the group C but regular treatment after the operation.Follow up was over six months.Results: 6 to 30 months after the treatment,success rate decreased from 86% to 65% in the group A,from 83% to 60% in the group B,and from 58% to 26% in the group C,respectively.Comparing with the group A and group B,the success of the group C was obvious lower ( P<0.05). The complications were less in the group A than in the group B.Conclusion:Both 5 Fu and MMC could restrain scaring in the filter bleb,and increase success of filtration surgery,however,MMC had better effect,and less complications than 5 Fu.