Iwach Andrew G, Delgado Maria F, Novack Gary D, Nguyen Ngoc, Wong Patricia C
Glaucoma Research & Education Group, San Francisco, California, USA.
Ophthalmology. 2003 Apr;110(4):734-42. doi: 10.1016/S0161-6420(02)01978-4.
To report the efficacy and safety of transconjunctival mitomycin-C as an adjunct to needle revision of failing filtering blebs.
Retrospective, consecutive, noncomparative interventional case series.
Forty-one patients (42 eyes) undergoing bleb revisions by a single surgeon at a single institution from May 1997 to January 2001.
The authors retrospectively reviewed charts of 42 eyes that underwent needle revision of the failing filtering bleb using transconjunctival application of mitomycin-C. Needling of the bleb was performed with a 25-gauge needle. The site of the needle puncture was sutured and followed by application of transconjunctival mitomycin-C (0.5 mg/ml) by means of a sponge left in contact with the conjunctival epithelium for 6 minutes. A group of patients received additional subconjunctival injections of 5-fluorouracil in the postoperative period. Success was defined as a reduction in intraocular pressure of 30% without the use of antiglaucoma medications and no further surgical procedures to control intraocular pressure.
Intraocular pressure, visual acuity, complications, number of glaucoma medications used at the final visit.
Mean preoperative intraocular pressure was 22.1 +/- 8.0 mmHg, which was reduced by 9.6 +/- 7.9 mmHg to a mean postoperative intraocular pressure of 12.5 +/- 6.1 mmHg. Mean follow-up was 17.6 +/- 13.5 months. Kaplan-Meier survival analysis showed a probability of continued success at 12 months of 76.1%, and at 24 months of 71.6%. The most common complication was hyphema in 7.1% of patients. Twenty-six eyes also received postoperative injections of 5-fluorouracil.
Transconjunctival mitomycin-C may enhance success of the needling procedure in failing filtering blebs.
报告经结膜应用丝裂霉素C辅助修复失败滤过泡针刺术的有效性和安全性。
回顾性、连续性、非对照性干预病例系列。
1997年5月至2001年1月在单一机构由同一位外科医生对41例患者（42只眼）进行滤过泡修复术。
作者回顾性分析42只眼的病历，这些眼采用经结膜应用丝裂霉素C进行失败滤过泡针刺修复术。用25号针进行滤过泡针刺。针刺部位缝合，然后用一块海绵将经结膜丝裂霉素C（0.5mg/ml）敷于结膜上皮，持续6分钟。一组患者在术后还接受了结膜下5-氟尿嘧啶注射。成功定义为在不使用抗青光眼药物的情况下眼压降低30%，且无需进一步手术控制眼压。
眼压、视力、并发症、末次随访时使用的青光眼药物数量。
术前平均眼压为22.1±8.0mmHg，术后平均眼压降低9.6±7.9mmHg，降至12.5±6.1mmHg。平均随访时间为17.6±13.5个月。Kaplan-Meier生存分析显示，12个月时持续成功的概率为76.1%，24个月时为71.6%。最常见的并发症是前房积血，发生率为7.1%。26只眼术后还接受了5-氟尿嘧啶注射。
经结膜应用丝裂霉素C可能提高失败滤过泡针刺术的成功率。
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