Sacu Stefan, Rainer Georg, Findl Oliver, Georgopoulos Michael, Vass Clemens
Department of Ophthalmology, University of Vienna Medical School, Vienna, Austria.
J Glaucoma. 2003 Oct;12(5):430-5. doi: 10.1097/00061198-200310000-00006.
To correlate the morphologic appearance of filtering blebs in the early postoperative period with the outcome of trabeculectomy with mitomycin C (MMC) during the first postoperative year.
In a prospective study, the morphologic appearance of filtering blebs after primary trabeculectomy with adjunctive MMC (0.1 mg/ml for 5 minutes intra-operatively) was classified; 49 eyes of 49 patients were examined preoperatively, 1 and 3 days, 1 and 2 weeks, 1, 3, 6, and 12 months postoperatively. Status of filtering bleb, intraocular pressure (IOP), and number of medications were recorded.
One year after surgery all patients had IOP < or = 21; 6 patients received antiglaucoma medication. One eye required needling of the filtering bleb because of encapsulation. During the first postoperative year, eyes with conjunctival subepithelial micro cysts, observed in the first and the second postoperative week, had significantly lower mean IOP, than eyes without (11.1 mm Hg vs. 13.9 mm Hg; p:0.0043, ANOVA). Eyes with corkscrew vessels, observed in the first and the second postoperative week, had significantly higher mean IOP, than eyes without during the first postoperative year (13.4 mm Hg vs. 11.7 mm Hg; p:0.0141, ANOVA).
Classification of filtering blebs after trabeculectomy with MMC may help to disclose patients with an increased failure risk.
将小梁切除术联合丝裂霉素C（MMC）术后早期滤过泡的形态外观与术后第一年的手术结果相关联。
在一项前瞻性研究中，对原发性小梁切除术联合辅助性MMC（术中0.1mg/ml，持续5分钟）后的滤过泡形态外观进行分类；对49例患者的49只眼在术前、术后1天和3天、1周和2周、1、3、6和12个月进行检查。记录滤过泡状态、眼压（IOP）和用药数量。
术后一年所有患者的眼压≤21；6例患者接受抗青光眼药物治疗。一只眼因滤过泡包囊化需要进行针刺。在术后第一年，术后第一周和第二周观察到有结膜上皮下微囊肿的眼，其平均眼压显著低于没有微囊肿的眼（11.1mmHg对13.9mmHg；p：0.0043，方差分析）。术后第一周和第二周观察到有螺旋状血管的眼，在术后第一年其平均眼压显著高于没有螺旋状血管的眼（13.4mmHg对11.7mmHg；p：0.0141，方差分析）。
小梁切除术联合MMC后对滤过泡进行分类可能有助于发现失败风险增加的患者。
