Yieh F S, Lu D W, Wang H L, Chou P I
Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
J Ocul Pharmacol Ther. 2001 Oct;17(5):443-8. doi: 10.1089/108076801753266820.
Antimetabolite therapy with 5-fluouracil (5-FU) or mitomycin-C (MMC) has significantly improved the success rate of glaucoma filtration surgery. However, in some eyes, when filtration is excessive, persistent hypotony may develop. In this study, we describe the experience of using autologous fibrinogen concentrate (AFC) to treat patients with persistent hypotony after glaucoma filtration surgery. Among seven MMC-augmented trabeculectomy patients who developed persistent postoperative hypotony, the effects of AFC intrableb injections were evaluated. Under a microscope, 0.2 ml AFC and bovine thrombin were injected into the blebs of the patients from both sides of the filtering blebs. Postoperative best-corrected visual acuity, anterior chamber status, intraocular pressure (IOP) and fundus examination were followed and compared with those preoperative. On the second day, the mean IOP of seven eyes elevated from preoperative 3.4 +/- 2.1 mmHg to 12.6 +/- 4.2 mmHg, and the anterior chamber became deep without obvious inflammatory response. Within two weeks, macular edema and visual acuity were noted to improve in six eyes (85.7%). In addition, after a mean follow-up of 25 months, the trabeculectomy procedure remained successful in all eyes. AFC appears to be safe and effective in the treatment of ocular hypotony after glaucoma filtration surgery.
使用5-氟尿嘧啶（5-FU）或丝裂霉素-C（MMC）进行抗代谢物治疗显著提高了青光眼滤过手术的成功率。然而，在一些眼中，当滤过过度时，可能会出现持续性低眼压。在本研究中，我们描述了使用自体纤维蛋白原浓缩物（AFC）治疗青光眼滤过手术后持续性低眼压患者的经验。在7例接受MMC辅助小梁切除术且术后出现持续性低眼压的患者中，评估了AFC眼内注射的效果。在显微镜下，从滤过泡两侧向患者的滤过泡内注射0.2 ml AFC和牛凝血酶。术后随访最佳矫正视力、前房状态、眼压（IOP）并进行眼底检查，并与术前情况进行比较。第二天，7只眼的平均眼压从术前的3.4±2.1 mmHg升高至12.6±4.2 mmHg，前房变深，无明显炎症反应。两周内，6只眼（85.7%）的黄斑水肿和视力得到改善。此外，平均随访25个月后，所有眼的小梁切除术均保持成功。AFC在治疗青光眼滤过手术后的眼内低眼压方面似乎是安全有效的。
