Hagiwara Y, Yamamoto T, Kitazawa Y
Department of Ophthalmology, Gifu University School of Medicine, Japan.
Graefes Arch Clin Exp Ophthalmol. 2000 Mar;238(3):232-6. doi: 10.1007/s004170050349.
We investigated in a prospective fashion the visual prognosis and complications in normal-tension glaucoma following unilateral trabeculectomy with adjunctive mitomycin C.
Trabeculectomy with adjunctive mitomycin C was carried out unilaterally in 21 cases of normal-tension glaucoma. Intraocular pressure (IOP), visual prognosis, and complications were compared between the operated eyes and the non-operated fellow eyes. The follow-up period ranged from 2 to 7 years.
The IOP dropped significantly from 14.8+/-1.8 mmHg (mean +/- SD) to 9.6+/-3.9 mmHg in the operated eyes (P=0.0002, Wilcoxon signed-rank test), but did not drop in the non-operated eyes. The mean deviation (MD) was -12.69+/-6.41 dB preoperatively and -14.70+/-5.49 dB at the last clinic visit in the operated eyes, whereas in non-operated eyes it was -7.85+/-5.65 dB and -11.15+/-5.62 dB, respectively. The MD deteriorated significantly in both operated and non-operated eyes (operated eyes P=0.0239, non-operated eyes: P=0.0002; Wilcoxon signed-rank test). The MD slope was -0.37+/-0.60 dB/year and -0.71+/-0.89 dB/year for the operated and non-operated eyes, respectively (P=0.5243, Mann-Whitney U-test). Visual field deterioration was more frequently observed in the non-operated eyes by a pointwise definition of the progression (P<0.05, McNemar test). Visual acuity deteriorated in 6 of the operated eyes and in 5 of the non-operated eyes. Cataract developed in 6 (29%) of the 21 operated eyes, while among the non-operated eyes 4 (19%) developed cataract.
Mitomycin C trabeculectomy is effective in delaying progression of visual field defect in normal-tension glaucoma, but complications may arise and cause some visual disturbance.
我们以前瞻性方式研究了单侧小梁切除术联合丝裂霉素C治疗正常眼压性青光眼后的视力预后及并发症。
对21例正常眼压性青光眼患者进行单侧小梁切除术联合丝裂霉素C治疗。比较手术眼与未手术的对侧眼的眼压（IOP）、视力预后及并发症。随访时间为2至7年。
手术眼的眼压从14.8±1.8 mmHg（平均值±标准差）显著降至9.6±3.9 mmHg（P = 0.0002，Wilcoxon符号秩检验），而未手术眼眼压未下降。手术眼术前平均偏差（MD）为-12.69±6.41 dB，末次门诊时为-14.70±5.49 dB，而未手术眼分别为-7.85±5.65 dB和-11.15±5.62 dB。手术眼和未手术眼的MD均显著恶化（手术眼P = 0.0239，未手术眼：P = 0.0002；Wilcoxon符号秩检验）。手术眼和未手术眼的MD斜率分别为-0.37±0.60 dB/年和-0.71±0.89 dB/年（P = 0.5243，Mann-Whitney U检验）。根据逐点定义的进展情况，未手术眼更频繁地观察到视野恶化（P < 0.05，McNemar检验）。手术眼有6例视力下降，未手术眼有5例视力下降。21只手术眼中有6只（29%）发生白内障，而未手术眼中有4只（19%）发生白内障。
丝裂霉素C小梁切除术在延缓正常眼压性青光眼视野缺损进展方面有效，但可能会出现并发症并导致一些视力障碍。
