翼状胬肉手术中单次滴注丝裂霉素C方案与其他丝裂霉素C方案的比较。

Comparison of single-drop mitomycin C regime with other mitomycin C regimes in pterygium surgery.

作者信息

Gupta Ved P, Saxena Tishu

机构信息

Department of Ophthalmology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.

出版信息

Indian J Ophthalmol. 2003 Mar;51(1):59-65.

PMID:12701864

Abstract

PURPOSE

To evaluate the safety and efficacy of single-drop instillation of mitomycin C (MMC) in pterygium surgery and to compare the results with both postoperative and intraoperative application of MMC.

METHODS

Eighty eyes of 72 patients with pterygium were randomised into 4 equal groups: group 1--control--bare scleral excision (BSE); group 2--BSE with single-drop instillation of mitomycin C (MMC) 0.02% at the end of the surgery; group 3--BSE with postoperative MMC 0.02% drops twice a day for 5 days; and group 4--BSE with intraoperative MMC 0.02%.

RESULTS

The recurrence of pterygium was observed in 14 (70%), 4 (20%), 4 (20%) and 3 (15%) eyes of group 1, 2, 3, and 4 respectively. The recurrence rate after BSE with single drop MMC regime (group 2) was significantly lower than group 1 recurrence (P=0.001) and was statistically comparable to that of group 3 and 4. Scleral defects in the bare area occurred in 4 (20%), 16 (80%) and 16 (80%) eyes of group 2, 3, and 4 respectively. The incidence of scleral defects was significantly lower in group 2 compared to group 3 (P=0.0001) and group 4 (P=0.0001). Compared to group 1 and 2, a significant delay in wound epithelialisation occurred in group 3 (P=0.003) and 4 (P=0.004). An ischaemic area in the bare sclera developed in 8 (40%) and 6 (30%) eyes of group 3 and 4 respectively, while ischaemic area did not develop in group 1 and 2.

CONCLUSION

Single-drop instillation of 0.02% mitomycin C following pterygium excision appears both safe and efficacious.

摘要

目的

评估丝裂霉素C（MMC）单滴法在翼状胬肉手术中的安全性和有效性，并将结果与MMC术后及术中应用进行比较。

方法

72例翼状胬肉患者的80只眼被随机分为4组，每组人数相等：第1组为对照组，行单纯巩膜切除术（BSE）；第2组在手术结束时行BSE并单滴0.02%丝裂霉素C（MMC）；第3组行BSE，术后每天滴注0.02%MMC滴眼液2次，共5天；第4组行BSE，术中应用0.02%MMC。

结果

第1、2、3和4组分别有14只眼（70%）、4只眼（20%）、4只眼（20%）和3只眼（15%）观察到翼状胬肉复发。采用MMC单滴法的BSE术后复发率（第2组）显著低于第1组（P=0.001），且与第3组和第4组在统计学上具有可比性。第2、3和4组分别有4只眼（20%）、16只眼（80%）和16只眼（80%）出现裸区巩膜缺损。第2组巩膜缺损的发生率显著低于第3组（P=0.0001）和第4组（P=0.0001）。与第1组和第2组相比，第3组（P=0.003）和第4组（P=0.004）伤口上皮化明显延迟。第3组和第4组分别有8只眼（40%）和6只眼（30%）出现裸区巩膜缺血区，而第1组和第2组未出现缺血区。