干扰素α-2b与丝裂霉素C用于青光眼滤过术的临床对比研究

目的 评价干扰素α－２ｂ（ｉｎｔｅｒｆｅｒｏｎ α－２ｂ,ＩＦＮ α－２ｂ）与丝裂霉素Ｃ（ｍｉｔｏｍｙｃｉｎ Ｃ,ＭＭＣ）用于青光眼滤过术的临床疗效及应用价值。方法 采取随机对照临床试验研究方法,将４１例（６８只眼）晚期原发性开角型青光眼（ｐｒｉｍａｒｙ ｏｐｅｎ ａｎｇｌｅ ｇｌａｕｃｏｍａ,ＰＯＡＧ）患者分为两组。每组各有３４只眼,其中２７例为同一患者左右眼对照;患者年龄１５～４０岁,均为衩手

A clinical comparative study of interferon alpha-2b with mitomycin C applied in glaucoma filtering operation

OBJECTIVE: To compare the results of interferon alpha-2b (IFN alpha-2b) with mitomycin C (MMC) treatment in trabeculectomy. METHOD: 41 cases 68 eyes with late stage of primary open angle glaucoma (POAG) were randomly studied by treatment with IFN alpha-2b or MMC following trabeculectomy, each group consisting of 34 eyes. Of the cases, 27 were bilateral, one eye was designed to use IFN alpha-2b, and the other eye, apply MMC. All patients were ranged from 15 to 40 years old, and they all received the surgery the first time. The surgical procedure was similar in all eyes. The IFN alpha-2b treated eyes were subconjunctivally injected 5 x 10(5) IU at filtering bleb when the operation was finished immediately and on the postoperative day 3, 7, 10 and 14, respectively. The MMC-receiving eyes were intraoperatively administered with 0.25 mg/ml via a sponge under the conjunctival flap for 5 minutes. The follow-up was ranged from 6 to 15 months. RESULTS: (1) The 12th month life-table success rate of functional bleb formation was (70.95 +/- 9.72)% in IFN alpha-2b-treated group and (77.01 +/- 10.51)% in MMC-received group, the difference being not statistically significant (u = 0.2165, P > 0.05). The eyes with IFN alpha-2b tended to form type II blebs were according to Kronfeld classification, whereas type I blebs were commonly seen in MMC-treated eyes (chi(2) = 6.261, P < 0.05). The percentages of intraocular pressure between 10 - 15 mmHg on postoperative month 3, 6, 9 and 12, respectively in IFN alpha-2b group were higher than that in MMC group. (2) The 12th month life-table complete and qualified success rates were (70.95 +/- 9.72)% and (94.59 +/- 5.26)% in IFN alpha-2b group, (65.15 +/- 10.51)% and (84.61 +/- 7.26)% in MMC group, respectively (u = 0.8174, 0.1011, P > 0.05). (3) Complications induced by IFN alpha-2b were rare, mainly involving transient corneal epithelial defect, whereas by MMC included thin-wall blebs, persistent hypotony and hypotonous maculopathy. The decrease of visual acuity was seen in 44.1% of the cases in MMC group, whereas only 17.6% occurred in IFN alpha-2b group (chi(2) = 5.217 4, P < 0.05). CONCLUSION: IFN alpha-2b has similar effect as MMC to reduce the risk of failure of glaucoma filtration surgery, but it has more advantages over because of its fewer complications.