低浓度丝裂霉素治疗翼状胬肉的随机、对照研究

目的:研究低浓度丝裂霉素在翼状胬肉治疗中的有效性和安全性。方法:前瞻、随机、对照临床试验,将确诊为翼状胬肉的400例患者550眼随机分为4组—第一组:100例患者的130眼,不使用丝裂霉素;第二组:100例患者的140眼,使用0.2g/L丝裂霉素;第三组:100例患者的150眼,使用0.3g/L丝裂霉素;第四组:100例患者的130眼,使用0.4g/L丝裂霉素。每组接受暴露巩膜的原发性翼状胬肉切除术。入选当天以及术后2wk;2,6mo;1a分别记录患者的视力、眼压、眼球运动、虹睫炎、疤痕、症状(流泪、畏光、异物感)和体征(结膜充血、角巩膜溃疡和巩膜穿孔)。结果:第三组和第四组的翼状胬肉术后复发率明显低于第一组和第二组(P<0.01)。术后第四组的眼压升高、虹睫炎、症状和体征的发生明显高于第一、二、三组。结论:低浓度丝裂霉素在预防翼状胬肉术后复发的治疗中是有效的。它的有效性随着浓度的增加而增加,同时,它的安全性随着浓度的增加而下降。

Efficacy and safety of low-dose mitomycin-C in the treatment of pterygium

·AIM:To observe the efficacy and the safety of low-dose mitomycin-C (MMC) in the treatment of pterygium.·METHODS:In a prospective,randomized and controlled clinical trial,a total of 550 eyes of 400 patients diagnosed with pterygium were randomly divided into the four groups-group 1:130 eyes of 100 patients,without MMC;group 2:140 eyes of 100 patients,with 0.2g/L MMC;group 3:150 eyes of 100 patients,with 0.3g/L MMC;group 4:130 eyes of 100 patients,with 0.4g/L MMC.They underwent the excision of primary pterygium barely the sclera.Visual acuity,intraocular pressure (IOP),extraocular movement,iridocyclitis,scarring, symptoms (tearing,photophobia,foreign body sensation) and signs (conjun-ctival hyperemia,ulcer of sclera and cornea,perforation of sclera) of subjects,were recorded on the day of enrollment,and after the surgery,on 2 weeks,2 months,6 months,and 1 year.·RESULTS:In group 3 and group 4,the recurrence of pterygium after the excision were less than that in group 1 and group 2 ( P < 0.01 ).In group 4,after the surgery,there were more probability of raising lOP,iridocyclitis,symptoms and signs than that in group 1,2,and 3.·CONCLUSION:Low-dose MMC is effective in the treatment of preventing the recurrence of primary pterygium.Its efficacy rises along with its density.And meantime,the safety of the treatment of low-dose MMC declines.