丝裂霉素C术中应用治疗难治性青光眼98例临床观察

目的探讨丝裂霉素C术中应用治疗难治性青光眼的临床效果。方法将不同类型的难治性青光眼患者90例(98眼)随机分为2组,观察组46例(50眼)术中应用丝裂霉素C,对照组44例(48眼)行常规小梁切除术。术后随访5～12个月,中位数8个月。观测患者的视力、眼压、滤过泡和并发症。结果 (1)2组术后视力比较差异无统计学意义(P>0.05)。(2)2组术后1周、6个月眼压与术前相比差异有统计学意义(P<0.01),且术后6个月观察组平均眼压低于对照组(P<0.05)。(3)功能性滤过泡:观察组(86.00%)高于对照组(64.58%),2组比较差异有统计学意义(P<0.05)。(4)不良反应:术后出现浅前房观察组较对照组多(30.00%vs 10.41%,P<0.05),前房出血差异无统计学意义(P>0.05)。结论与常规小梁切除术相比,丝裂霉素C术中应用治疗难治性青光眼,在防止滤过道瘢痕形成,术后控制眼压等方面有一定优势。

Trabeculectomy combined with mitomycin-C in treating 98 cases of refractory glaucoma

Objective To investigate the clinical effect of compound trabeculectomy combined with mitomycin-C in treating of refractory glaucoma.Methods 90 patients(98 eyes) were randomly assigned to receive trabeculectomy with or without mitomycin-C.The observes group(46 patients with 50 eyes) underwent trabeculectomy combined with mitomycin-C. The control group(44 patients with 48 eyes) underwent conventional trabeculectomy.During the average follow up of 8 months(5 to 12 months),main outcome of measurement of visual acuity,intraocular pressures(IOP),filtering blebs and complications were examined and recoreded.Results(1) No significant differences in visual acuity were found between two groups(P>0.05 ).(2) Significant differences in IOPs on one week or 6 months after the surgery were found between the two groups(P<0.01).The average post-operative IOP at the 6th months in the observer group was significantly lower(P<0.05 ).(3 ) The percentage of functional filtering blebs in the observer group was 86.00%,significantly higher than that of 64.58%in the control group(P<0.05).(4) The incidence rate of shallow anterior chamber in the observer group was higher than that of the control group(30.00%vs.10.41%,P<0.05),but bleeding in anterior chamber after surgery between the two groups was not significant differences(P>0.05).Conclusion The trabeculectomy combined with mitomycin-C has the advantages of preventing post-operative scar formation and achieving better control of post-operative IOP over the conventional trabeculectomy in treating refractory glaucoma.