Hosseini Hamid, Mehryar Morsal, Farvardin Mohsen
Shiraz University of Medical Sciences, Ophthalmology Department, Khalili Hospital, Shiraz, Iran.
Med Hypotheses. 2007;68(2):401-3. doi: 10.1016/j.mehy.2006.04.075. Epub 2006 Aug 17.
Glaucoma is one of the most common causes of irreversible blindness worldwide. Despite continued advances in medical and laser therapy, incisional surgery still appears to be an important and for many cases the only option by which intraocular pressure is controlled. Unlike many other types of surgery in which complete healing of tissue would be a desirable outcome, glaucoma surgery seeks to achieve incomplete healing to allow aqueous humor to escape the eye. Pharmacologic modulation of wound healing is a hot topic in glaucoma filtration surgery. Although routine antifibrotic medications are associated with good results in modulating wound healing in glaucoma surgery, they carry with them the possibility for significant morbidity due to the adverse effects of treatment. Challenge continues to be to find a safe and effective agent for this purpose. Because of beneficial effects of triamcinolone acetonide in some conditions which are associated with secondary glaucoma and also potential effects of this agent in modulating wound healing process, we propose it as a useful adjunct to glaucoma filtration surgery. This approach may allow modulation of wound healing with less of the toxicity associated with commonly used antifibrotics (5-FU and mitomycin C).
青光眼是全球不可逆性失明的最常见原因之一。尽管药物和激光治疗不断取得进展，但切开手术似乎仍是控制眼压的重要手段，在许多情况下也是唯一的选择。与许多其他类型的手术不同，在那些手术中组织完全愈合是理想的结果，而青光眼手术旨在实现不完全愈合，以使房水能够逸出眼球。伤口愈合的药理学调节是青光眼滤过手术中的一个热门话题。尽管常规抗纤维化药物在调节青光眼手术中的伤口愈合方面取得了良好效果，但由于治疗的不良反应，它们存在导致严重发病的可能性。持续面临的挑战是为此找到一种安全有效的药物。由于曲安奈德在一些与继发性青光眼相关的病症中具有有益作用，并且该药物在调节伤口愈合过程中也具有潜在作用，我们建议将其作为青光眼滤过手术的有用辅助药物。这种方法可能允许在调节伤口愈合的同时，减少与常用抗纤维化药物（5-氟尿嘧啶和丝裂霉素C）相关的毒性。
