Iester Michele, Ravinet Emilie, Mermoud André
Hospital Ophtalmique Jules Gonin, University of Lausanne, Switzerland.
J Ocul Pharmacol Ther. 2002 Aug;18(4):307-12. doi: 10.1089/10807680260218470.
To evaluate subconjunctival mitomycin C (MMC) injection efficacy and safety in patients with failing glaucoma non-penetrating filtering blebs.
Twenty-eight eyes were consecutively recruited for this study. Only one eye for each patient was randomly selected. All the recruited patients had glaucoma and uncontrolled intraocular pressure after a non-penetrating filtering glaucoma surgery and/or a pathological aspect of the filtering bleb (i.e., vascularized and/or encysted). One or more MMC injections were performed under the conjunctiva closed to the bleb to improve filtration. Local effects and complications of subconjunctival MMC injections were analyzed.
Out of the 28 patients, 21 (75%) had MMC also applied intraoperatively. The mean postoperative IOP before MMC injections was 17 +/- 6.6 mmHg. The final IOP after MMC injections was 13.9 +/- 2.9 mmHg after a mean follow-up of 6 months. A total of 67 subconjunctival MMC injections were performed with a mean of 2.9 (ranging from 1 to 5) injections per patient. The only complication found to be possibly related to MMC injections was two cases of corneal Dellen.
From these preliminary results, subconjunctival MMC injections in selected cases appear to be not only safe but also effective in promoting further the postoperative IOP drop.
评估结膜下注射丝裂霉素C(MMC)对青光眼非穿透性滤过泡失败患者的疗效和安全性。
本研究连续纳入28只眼。每位患者仅随机选取一只眼。所有纳入患者均患有青光眼,且在非穿透性滤过性青光眼手术后眼压未得到控制和/或滤过泡存在病理表现(即血管化和/或囊肿化)。在靠近滤过泡的结膜下进行一次或多次MMC注射以改善滤过。分析结膜下注射MMC的局部效应和并发症。
28例患者中,21例(75%)术中也应用了MMC。MMC注射前的平均术后眼压为17±6.6 mmHg。平均随访6个月后,MMC注射后的最终眼压为13.9±2.9 mmHg。共进行了67次结膜下MMC注射,每位患者平均注射2.9次(范围为1至5次)。发现唯一可能与MMC注射相关的并发症是2例角膜小凹。
从这些初步结果来看,在选定病例中结膜下注射MMC似乎不仅安全,而且在促进术后眼压进一步降低方面有效。