Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China.
J Glaucoma. 1993 Winter;2(4):260-5.
Subconjunctival fibrosis is one of the major causes of most bleb failures. To inhibit the wound-healing process and to achieve a better intraocular pressure (IOP) lowering effect as well as bleb formation, we performed a sclerostomy using a THC:YAG laser (thulium, holmium, and chromium-doped yttrium-aluminum-garnet crystal) and a subconjunctival injection of mitomy-cin-C given 24 h or 5 days before a filtering operation or soon after the filtering process in rabbits. A 1-mm conjunctiva wound was made 12 mm away from the sclerostomy site to allow for entry of an optic probe for delivering energy. Forty-eight rabbits were divided into four groups. Group I received a subconjunctival injection of 0.2 ml of 0.2 mg/ml of mitomycin-C 24 h before the operation. The same dosage of mitomycin-C was given to Group II 5 days before the operation and to Group III immediately following the operation. Group IV served as a control, and only 0.2 ml of normal saline solution was given 24 h preoperatively. One eye of each rabbit was randomly selected for the experiment, while the other eye served as a control. The bleb lasted 30.9 $pM 15.7 days in Group I, 16.0 $pM 6.4 days in Group II, 15.5 $pM 6.5 days in Group III, and 2.3 $pM 0.7 days in Group IV. The IOP lowering effect was parallel to bleb formation. The results demonstrate that a subconjunctival mitomycin-C injection given 24 h before a filtering operation is more effective in prolonging the filtering effect produced by the THC:YAG laser than one given postoperatively.
结膜下纤维化是大多数滤泡失败的主要原因之一。为了抑制伤口愈合过程，达到更好的眼压（IOP）降低效果和滤泡形成效果，我们在兔子的滤过手术前 24 小时或 5 天进行了 THC：YAG 激光（掺铥、钬和铬的钇铝石榴石晶体）巩膜造瘘术，并在滤过过程后不久进行了结膜下丝裂霉素 C 注射。在距巩膜造瘘部位 12mm 处做 1mm 的结膜伤口，允许光学探头进入以输送能量。48 只兔子分为四组。第 I 组在手术前 24 小时结膜下注射 0.2ml0.2mg/ml 的丝裂霉素 C。第 II 组和第 III 组在手术前 5 天和手术后立即给予相同剂量的丝裂霉素 C。第 IV 组作为对照组，仅在术前 24 小时给予 0.2ml 生理盐水。每只兔子的一只眼随机用于实验，另一只眼作为对照。第 I 组的滤泡持续时间为 30.9$pM15.7 天，第 II 组为 16.0$pM6.4 天，第 III 组为 15.5$pM6.5 天，第 IV 组为 2.3$pM0.7 天。眼压降低效果与滤泡形成平行。结果表明，滤过手术前 24 小时结膜下注射丝裂霉素 C 比术后注射更能延长 THC：YAG 激光产生的滤过效果。
