Ben Simon Guy J, Glovinsky Yoseph
The Goldschleger Eye Institute, Sheba Medical Center, Sackler School of Medicine at Tel Aviv University, Tel Aviv, Israel.
Clin Exp Ophthalmol. 2006 Nov;34(8):765-70. doi: 10.1111/j.1442-9071.2006.01305.x.
To evaluate the safety and efficacy of primary trabeculectomy with brief exposure (15 s) to mitomycin C (MMC) (0.4 mg/mL).
Medical record review of all patients who underwent primary trabeculectomy with brief exposure to MMC at the Goldschleger Eye Institute in a 4-year period was performed.
Sixty-three patients (35 men, mean age of 55 years) underwent trabeculectomy with brief exposure to MMC. Intraocular pressure (IOP) decreased a mean +/- standard deviation of 17.9 +/- 9.6 mmHg from 30.4 +/- 9.5 mmHg preoperatively to 12.5 +/- 6.2 mmHg postoperatively after a mean follow up of 18.3 months (P < 0.001). Number of antiglaucoma medications decreased from 2.9 +/- 1.1 preoperatively to 0.2 +/- 0.4 postoperatively (P < 0.001, paired samples t-test). Complete success, defined as IOP < 18 mmHg without antiglaucoma medication, was achieved in 46 patients (73%) and qualified success, defined as IOP <or= 21 mmHg with or without antiglaucoma medications, was achieved in 59 patients (93.7%). Thirty-eight patients (60%) had a final IOP < 15 mmHg with no glaucoma medications at the end of follow up. Needle revision was required in four patients (6.3%) and repeated trabeculectomy was performed in three patients (4.8%). Four patients had an IOP of less than 6 mmHg at the end of follow-up period (three had final IOP of 5 mmHg and one of 4 mmHg); these patients had an average larger bleb size (2.8 +/- 1.3).
Trabeculectomy with brief (15 s) exposure to MMC 0.4 mg/mL is safe and effective in lowering IOP in this group of patients, and results in low rate of postoperative complications. Success is comparable to reported data with longer exposure durations to antimetabolites.
评估原发性小梁切除术联合短暂暴露（15秒）于丝裂霉素C（MMC，0.4毫克/毫升）的安全性和有效性。
对在戈德施莱格眼科研究所4年期间接受原发性小梁切除术并短暂暴露于MMC的所有患者进行病历回顾。
63例患者（35例男性，平均年龄55岁）接受了小梁切除术并短暂暴露于MMC。平均随访18.3个月后，眼压（IOP）从术前的30.4±9.5毫米汞柱降至术后的12.5±6.2毫米汞柱，平均降低了17.9±9.6毫米汞柱（P<0.001）。抗青光眼药物的数量从术前的2.9±1.1降至术后的0.2±0.4（P<0.001，配对样本t检验）。46例患者（73%）实现了完全成功，定义为眼压<18毫米汞柱且无需使用抗青光眼药物；59例患者（93.7%）实现了合格成功，定义为眼压≤21毫米汞柱，无论是否使用抗青光眼药物。38例患者（60%）在随访结束时眼压<15毫米汞柱且未使用青光眼药物。4例患者（6.3%）需要进行针刺修复，3例患者（4.8%）进行了重复小梁切除术。4例患者在随访期结束时眼压低于6毫米汞柱（3例最终眼压为5毫米汞柱，1例为4毫米汞柱）；这些患者的滤过泡平均较大（2.8±1.3）。
原发性小梁切除术联合短暂（15秒）暴露于0.4毫克/毫升的MMC在降低该组患者眼压方面是安全有效的，且术后并发症发生率较低。成功率与报道的抗代谢物暴露时间较长的数据相当。
