Blumenthal M, Glovinsky Y
Goldschleger Eye Institute, Sheba Medical Center, Tel Aviv University, Tel Hashomer, Israel.
Curr Opin Ophthalmol. 1995 Apr;6(2):15-8. doi: 10.1097/00055735-199504000-00004.
Of the three classical approaches to surgery for coexisting cataract and glaucoma, last year's publications dealt with the surgical consequences of combined cataract and glaucoma operations only. When used in combined cataract and glaucoma surgery, a small-incision extracapsular cataract extraction (ECCE) with phacoemulsification (PHACO) was found to be only slightly superior to the standard manual ECCE in terms of postoperative intraocular pressure (IOP) control. Injections of 5-fluorouracil postoperatively did not improve IOP control in PHACO-ECCE-trabeculectomy or manual ECCE-trabeculectomy. A preliminary uncontrolled report suggests, however, that intraoperative mitomycin C application in PHACO-ECCE-trabeculectomy may result in excellent postoperative IOP control without antiglaucomatous medications, and with no significant mitomycin C-related complications. Controlled studies on mitomycin C application in small-incision cataract and glaucoma surgery are needed to assess its long-term effect on IOP and astigmatism.
在治疗白内障合并青光眼的三种经典手术方法中，去年的出版物仅涉及白内障合并青光眼联合手术的手术后果。在白内障合并青光眼手术中使用时，发现小切口白内障囊外摘除术（ECCE）联合超声乳化术（PHACO）在术后眼压（IOP）控制方面仅略优于标准手法ECCE。术后注射5-氟尿嘧啶在PHACO-ECCE小梁切除术或手法ECCE小梁切除术中并不能改善眼压控制。然而，一份初步的非对照报告表明，在PHACO-ECCE小梁切除术中术中应用丝裂霉素C可能无需使用抗青光眼药物即可实现出色的术后眼压控制，且无明显的丝裂霉素C相关并发症。需要对丝裂霉素C在小切口白内障和青光眼手术中的应用进行对照研究，以评估其对眼压和散光的长期影响。
