紫杉醇在青光眼滤过术后的抗增殖作用

目的　探讨紫杉醇对青光眼滤过术后的抗增殖作用。方法　选取山东省菏泽市立医院眼科２０１０年１月至２０１４年６月收治的原发性闭角型青光眼患者９６例（１０４眼），随机分为４组:Ａ组术中给予０．２０ｇ·Ｌ－１丝裂霉素Ｃ，Ｂ、Ｃ、Ｄ组术中分别给予０．０３ｇ·Ｌ－１、０．０５ｇ·Ｌ－１、０．１０ｇ·Ｌ－１紫杉醇。所有患者均行标准的小梁切除术，术后均随访６个月，对患者术后１周、１个月、３个月、６个月的视力、眼压、滤过泡、并发症等情况进行观察记录。结果　４组患者术前视力组间差异无统计学意义（均为Ｐ＞０．０５），术后不同时间组间差异均无统计学意义（均为Ｐ＞０．０５），术后与术前比较，差异也均无统计学意义（均为Ｐ＞０．０５）。术后１周、１个月、３个月与６个月，４组患者的功能性滤过泡比率差异均无统计学意义（χ２ ＝０．０００、０．７３９、１．０３１、１．０８３，均为Ｐ＞０．０５）。４组患者的术前眼压、术后１周眼压差异均无统计学意义（均为Ｐ＞０．０５），术后１个月、３个月、６个月Ａ组与Ｄ组间眼压差异均无统计学意义（均为Ｐ＞０．０５），Ｄ组与Ｂ组、Ｃ组差异均有统计学意义（均为Ｐ＜０．０５）。术后Ａ组有２眼结膜伤口有轻度渗漏，４眼发生浅前房，其余３组均未出现以上情况。结论　紫杉醇用于青光眼滤过术能有效降低眼压，维持滤过泡功能，且副作用较小。

Anti-proliferative effects of paclitaxel after glaucoma filtering surgery

Objective To summarize the clinical effects of paclitaxel after glaucoma filtering surgery. Methods A total of 96 primary angle closure glaucoma patients( 104 eyes) from January 2010 to June 2014 in Department of Ophthalmology of Heze Municiple Hospital were selected , they were randomly divided int0 4 groups : Group A:O. 20 g . L-1 mitomycin C was given; Group B:O. 03 g . L-I paclitaxel was given; Group C :0. 05 g . L-l paclitaxel was given ; Group D:O. 10 g . L-l paclitaxel was given. The routine standard trabeculectomy was performed in all patients , the mean follow-up time was 6 months , the visual acuity , intraocular pressure , filtering bleb and complications at postoperative I week, I month.3 months and 6 months were recorded. Results There was no statistical difference in preoperative visual acuity among four groups ( all P > 0. 05 ) , no statistical difference in postoperative visual acuity at different time points among four groups( all P > 0. 05 ) . and no statistical difference between preoperative and postoperative visual acuity of four groups( all P > 0. 05 ) . There was no statistical difference in functional filtering bleb at postoperative I week.l month.3 months and 6 months among four groups (X2 = 0. 000 ,0. 739 , 1. 031 ,1. 083 . all P > 0. 05 ) . There was no statistical difference in intraocular pressure between pre-operation and I week postoperative of four groups( all P > 0. 05 ) . and there was no statistical difference in intraocular pressure at postoperative I month, 3 months and 6 months between group A and D( all P > 0. 05 ) .while there were statistical differences between group D and group B,C ( all P < 0. 05 ). The slight leakage of conjunctival incision appeared in 2 eyes of group A, the shallow anterior chamber were happened in 4 eyes, the other three groups had no above complications. Conclusion Paclitaxel used in the filtration operation for glaucoma can effectively decrease intraocular pressure and maintain the functional filtering bleb with few complications.