Fukuchi Takeo, Ueda Jun, Yaoeda Kiyoshi, Suda Kieko, Seki Masaaki, Abe Haruki
Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Jpn J Ophthalmol. 2006 Jul-Aug;50(4):338-344. doi: 10.1007/s10384-005-0323-8.
To analyze the results of mitomycin C (MMC) trabeculectomy and laser suture lysis using either fornix-based (FB) or limbus-based (LB) conjunctival flaps.
Eighty-two Japanese glaucoma patients were treated by MMC trabeculectomy, with 38 eyes receiving an FB conjunctival flap and 44 eyes receiving an LB conjunctival flap. Postoperative intraocular pressure (IOP), the probability of success, and complications were compared between the FB and LB groups.
The IOP of the FB group decreased from 21.6+/-7.90 mmHg to 9.75+/-3.23 mmHg at 12 months postoperation, and the IOP of the LB group decreased from 21.3+/-6.77 mmHg to 9.30+/-3.16 mmHg. The postoperative IOPs were similar in the two groups at all postoperative time points. A life-table analysis (Kaplan-Meier method) showed that the survival rate was similar in the two groups but tended to be lower in the early postoperative period in the FB group. Complications were similar also, with the exception of increased leakage in the FB group.
MMC trabeculectomy results were similar between FB and LB conjunctival flaps, in agreement with previous reports. However, increased care may be warranted when an FB flap is used in MMC trabeculectomy.
分析采用穹窿部结膜瓣(FB)或角膜缘结膜瓣(LB)进行丝裂霉素C(MMC)小梁切除术及激光缝线松解术的结果。
82例日本青光眼患者接受了MMC小梁切除术,其中38眼采用FB结膜瓣,44眼采用LB结膜瓣。比较FB组和LB组术后的眼压(IOP)、手术成功率及并发症。
FB组术后12个月眼压从21.6±7.90 mmHg降至9.75±3.23 mmHg,LB组眼压从21.3±6.77 mmHg降至9.30±3.16 mmHg。两组在所有术后时间点的术后眼压相似。生存分析(Kaplan-Meier法)显示两组生存率相似,但FB组术后早期生存率有降低趋势。并发症情况也相似,只是FB组渗漏增加。
FB结膜瓣和LB结膜瓣的MMC小梁切除术结果相似,与既往报道一致。然而,在MMC小梁切除术中使用FB瓣时可能需要格外注意。