丝裂霉素C联合粘小管成形术治疗开角型青光眼的疗效

目的:评估丝裂霉素C(MMC)联合粘小管成形术治疗开角型青光眼的效果.方法:回顾性研究.收集2007-12/2014-03接受粘小管成形术患者104例122眼.记录术前术后眼内压(IOP),青光眼用药数量,视力,并发症,辅助治疗(激光前房角穿刺或青光眼用药)和成功率.IOP≤21 mmHg无额外用药为完全成功,IOP≤21 mmHg有或无青光眼用药为部分成功.结果:术前平均IOP为27.5±9.2 mmHg,术后平均IOP为14.5±6.6 mmHg(P<0.001).术前平均视力为0.42±0.4,术后为0.32±0.4 (P=0.726).部分成功106眼(86.9%),完全成功62眼(50.8%).激光前房角穿刺术43眼(35.2%),青光眼药物使用率为49.1%.术后平均随访27.29±16.78 (1~79)mo.结论:粘小管成形术并发症发生率低且术后视力稳定,是一种安全的选择,术后补充进行激光前房角穿刺术可以提高手术成功率.丝裂霉素C对于粘小管成形术的作用还需进行深入的比较研究.

Results of mitomycin-C-augmented viscocanalostomy for open-angle glaucoma

AIM:To evaluate the results of mitomycin-C (MMC)-augmented viscocanalostomy in patients with open-angle glaucoma.METHODS:This retrospective study included 104 patients who underwent viscocanalostomy surgery between December 2007 and March 2014.Pre-and postoperative intraocular pressure (IOP), number of glaucoma medications, visual acuity, complications, adjunctive procedure (laser goniopuncture and/or glaucoma medication), and success rate were recorded.Complete success was defined as IOP≤21 mmHg without additional medication, and qualified success was defined as IOP≤21 mmHg with or without glaucoma medication.RESULTS:Mean preoperative IOP was 27.5±9.2 mmHg and mean postoperative IOP was 14.5±6.6 mmHg at the last visit (P<0.001).Mean visual acuity before and after surgery were 0.42±0.4 and 0.32±0.4, respectively (P=0.726).Qualified success was achieved in 106 (86.9%) eyes and complete success was achieved in 62 (50.8%) eyes.Laser goniopuncture was performed in 43 (35.2%) eyes and glaucoma medication usage rate was 49.1%.The mean postoperative followup period was 27.29±16.78 (1-79)mo.CONCLUSION:Although viscocanalostomy is a safer option due to low complication rates and stable visual acuity, without laser goniopuncture(LGP), surgical success rate is still very low.Further comparative studies are necessary to evaluate the contribution of MMC to viscocanalostomy surgery.