Lee Kyoungsook, Hyung Sungmin
Department of Ophthalmology, Chungbuk National University School of Medicine, Cheongju, Korea.
Korean J Ophthalmol. 2009 Dec;23(4):281-5. doi: 10.3341/kjo.2009.23.4.281. Epub 2009 Dec 4.
To evaluate the efficacy of excision of avascular bleb and advancement of adjacent conjunctiva (EBAC) for treatment of hypotony after trabeculectomy with mitomycin C (MMC).
Fifteen patients (17 eyes) who received EBAC for correction of hypotony between September 1996 and October 2008 were reviewed retrospectively. The main outcomes were intraocular pressure (IOP) and postoperative complications.
Hypotony (IOP <6 mmHg) of eight eyes (47.1%, seven patients) was caused by bleb perforation. Of these, two eyes (two patients) had a history of trauma. Hypotony appeared at 33.9+/-30.8 months, and EBAC was performed at 48.2+/-35.3 months after trabeculectomy with MMC. The mean follow-up period was 38.3+/-29.8 months. The qualified success rate of EBAC was 100% at 51 months after EBAC, and the complete success rate of EBAC was 76.5% at six months and 70.6% at 51 months, as determined by Kaplan-Meier analysis. Post-EBAC complications included blepharoptosis in four eyes (23.5%) and bleb perforation in one (5.9%). The blepharoptosis resolved within one month after EBAC in two patients. However, in the other patients, mild blepharoptosis remained at 17 and 22 months postoperatively.
EBAC was found to be an effective method for treatment of hypotony after trabeculectomy with MMC, and postoperative blepharoptosis was a major complication.
评估无血管性滤过泡切除术联合邻近结膜前移术（EBAC）治疗丝裂霉素C（MMC）小梁切除术后低眼压的疗效。
回顾性分析1996年9月至2008年10月期间接受EBAC治疗低眼压的15例患者（17只眼）。主要观察指标为眼压（IOP）和术后并发症。
8只眼（47.1%，7例患者）的低眼压（IOP<6mmHg）是由滤过泡穿孔引起的。其中，2只眼（2例患者）有外伤史。低眼压出现在小梁切除联合MMC术后33.9±30.8个月，EBAC在术后48.2±35.3个月进行。平均随访期为38.3±29.8个月。根据Kaplan-Meier分析，EBAC术后51个月的合格成功率为100%，术后6个月的完全成功率为76.5%，51个月时为70.6%。EBAC术后并发症包括4只眼（23.5%）上睑下垂和1只眼（5.9%）滤过泡穿孔。2例患者的上睑下垂在EBAC术后1个月内缓解。然而，在其他患者中，术后17个月和22个月仍有轻度上睑下垂。
EBAC是治疗MMC小梁切除术后低眼压的有效方法，术后上睑下垂是主要并发症。
