针拨联合丝裂霉素C结膜下注射治疗抗青光眼术后失败滤过泡

目的:观察利用针拨联合丝裂霉素C结膜下注射治疗抗青光眼术后失败滤过泡的效果。方法:对抗青光眼小梁手术后3~22wk失败滤过泡34例(35眼)用针拨联合丝裂霉素C滤过泡旁注射,并随访6mo以上,观察滤过泡重新形成和眼压下降情况。结果:成功29例(29眼),手术前平均眼压为23.74±6.2mmHg,手术后眼压平均为13±4.3mmHg。其中3例(3眼)重复针拨、注射。随访期结束后统计针拨前后眼压具有显著性差异,Kaplan-Meier生存分析2a滤过泡成功率82.9%±6.4%。针拨术中有4眼前房出血,2眼低眼压,未见丝裂霉素的其它毒性反应。结论:针拨联合丝裂霉素C结膜下注射可以重新建立功能性滤过泡,有效地控制眼压,减少青光眼患者再次手术的痛苦。它是挽救抗青光眼术后失败滤过泡的一种良好的方法,具有毒性小、安全可重复的特点。

Needle revision with mitomycin C subconjunctival injection on the dysfunctional filtering blebs after trabeculectomy

AIM: To investigate the efficacy of needle revision with mitomycin C(MMC) on the dysfunctional filtration blebs after trabeculectomies.·METHODS: Thirty-four patients (35 eyes) underwent the needle revision of the dysfunctional blebs with MMC at clinic visits in 3-22 weeks after trabeculectomy and observed blebs reformation and the descent of intraocular pressure( IOP) followed up for more than 6 months.·RESULTS: After revision through needling procedures, IOP were significantly decreased from (23.74±6.2)mmHg to (13±4.3)mmHg in 29 functional filtering blebs. Three eyes of them were suffered needle revision with MMC subconjunctival injection again. The Kaplan-Meier survi-val curve for the 35 eyes showed a success rate of (82.9±6.4)% within 2 years. During the needle revision, anterior chamber hemorrhage occurred in 4 eyes and ocular hypotension in 2 eyes, and no other post-needling com-plications were found during the follow-up time.·CONCLUSION: The needle revision combined with MMC can successfully revive a failed filtration blebs and better control of IOP without the expense and risks asso-ciated with more invasive procedures in the operating room. It is an effective, safe, and repeatable method of improving dysfunctional filtration blebs after trabeculectomy.