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原发性青光眼手术中低剂量术中丝裂霉素-C与5-氟尿嘧啶的比较:一项初步研究。

Comparison of low-dose intraoperative mitomycin-C vs 5-fluorouracil in primary glaucoma surgery: a pilot study.

作者信息

Vijaya L, Mukhesh B N, Shantha B, Ramalingam S, Sathi Devi A V

机构信息

Sankara Nethralaya Medical Research Foundation, Chennai Tamil Nadeu, India.

出版信息

Ophthalmic Surg Lasers. 2000 Jan-Feb;31(1):24-30.

Abstract

BACKGROUND AND OBJECTIVE

This study was undertaken to compare the efficacy and safety of low-dose intraoperative application of mitomycin-C (MMC) with that of 5-fluorouracil (5-FU) in primary trabeculectomy.

PATIENTS AND METHODS

A non-randomized prospective study was performed between August 1994 and November 1995. Thirty-two eyes of 16 consecutive patients who underwent trabeculectomy for uncontrolled glaucoma of various causes form the study group. The mean age was 46.8 +/- 9.9 years. The first eye received MMC (0.2, 0.4 mg/ml), fellow eye received 5-FU (50 mg/ml), for 1 minute intraoperatively. Bleb characteristics and intraocular pressure (IOP) control were analyzed. Success of surgery based on IOP control was measured by 3 different criteria: IOP less than 21 mm Hg; IOP less than 21 mm Hg with more than 30% reduction; and IOP less than 16 mm Hg with more than 30% reduction.

RESULTS

Mean preoperative IOP was 31.4 +/-12.7 mm Hg in MMC group and 27.8+/- 8.8 mm Hg in 5-FU group. Mean follow-up in MMC group was 16.12 +/- 8.17 months; in 5-FU group 13.37 +/- 8.19 months. At last follow-up all 5-FU blebs were nonischemic, while 4 eyes in the MMC group showed nonischemic blebs, and 12 eyes had ischemic blebs. There was no statistically significant difference between MMC group and 5-FU group success rates with all 3 criteria. Success rates were: IOP less than 21 mm Hg; 100% in both groups; IOP less than 21 mm Hg with more than 30% reduction; MMC group 93.8%, 5-FU group 75%; less than 16 mm Hg with more than 30% reduction; MMC group 87.5%, 5-FU group 68.8%.

CONCLUSIONS

Low-dose intraoperative MMC and 5-FU can provide control of IOP in primary trabeculectomy, 5-FU group showed more non-ischemic blebs.

摘要

背景与目的

本研究旨在比较原发性小梁切除术中低剂量术中应用丝裂霉素-C(MMC)与5-氟尿嘧啶(5-FU)的疗效和安全性。

患者与方法

1994年8月至1995年11月进行了一项非随机前瞻性研究。连续16例因各种原因导致的难治性青光眼接受小梁切除术的患者的32只眼构成研究组。平均年龄为46.8±9.9岁。第一只眼术中接受MMC(0.2、0.4mg/ml),另一只眼接受5-FU(50mg/ml),持续1分钟。分析滤过泡特征和眼压(IOP)控制情况。根据IOP控制情况衡量手术成功率,采用3种不同标准:IOP低于21mmHg;IOP低于21mmHg且降低超过30%;IOP低于16mmHg且降低超过30%。

结果

MMC组术前平均IOP为31.4±12.7mmHg,5-FU组为27.8±8.8mmHg。MMC组平均随访16.12±8.17个月;5-FU组平均随访13.37±8.19个月。在最后一次随访时,所有5-FU滤过泡均为非缺血性,而MMC组4只眼显示非缺血性滤过泡,12只眼有缺血性滤过泡。MMC组和5-FU组在所有3种标准下的成功率无统计学显著差异。成功率分别为:IOP低于21mmHg;两组均为100%;IOP低于21mmHg且降低超过30%;MMC组93.8%,5-FU组75%;IOP低于16mmHg且降低超过30%;MMC组87.5%,5-FU组68.8%。

结论

原发性小梁切除术中低剂量术中应用MMC和5-FU均可控制IOP,5-FU组显示更多非缺血性滤过泡。

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