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冻干羊膜移植联合丝裂霉素C及小梁切除术治疗儿童青光眼

A freeze-dried (lyophilized) amniotic membrane transplantation with mitomycin C and trabeculectomy for pediatric glaucoma.

作者信息

Mahdy Reda A, Nada Waled M, Almasalamy Salah M, Anany Hesham A, Almasary Ayman M

机构信息

Department of Ophthalmology, Faculty of Medicine, Zagazig University, Zagazig, Sharkia, Egypt.

出版信息

Cutan Ocul Toxicol. 2010 Sep;29(3):164-70. doi: 10.3109/15569521003775005.

Abstract

PURPOSE

To evaluate the potential usefulness of a freeze-dried (lyophilized) amniotic membrane transplantation with mitomycin C (MMC) in the maintenance of functioning glaucoma surgery in cases of pediatric glaucoma.

METHODS

Thirty eyes of pediatric patients with glaucoma were included in this study. Trabeculectomy with amniotic membrane implantation and MMC was done in group 1 (15 eyes), and trabeculectomy with MMC only was done in group 2 (15 eyes). The preserved amniotic membrane was placed over the scleral flap and under the conjunctiva. The mean intraocular pressure (IOP) was measured pre- and postoperatively and bleb appearance was noted. The follow-up time was 18 months after surgery.

RESULTS

The mean postoperative IOP was significantly decreased to 15 +/- 1 mm Hg and 17.2 +/- 2.9 mm Hg in the 2 groups, respectively. The bleb was functioning well in the follow-up period in most of the cases, except 5 cases that needed another surgery. Complications such as inflammation, choroidal detachment, or toxic keratopathy were not noted in group 1 but were noted in group 2.

CONCLUSION

Trabeculectomy with amniotic membrane transplantation and MMC can effectively control the elevated IOP in pediatric patients with glaucoma without significant postoperative complications.

摘要

目的

评估冻干羊膜移植联合丝裂霉素C(MMC)在维持小儿青光眼手术功能方面的潜在效用。

方法

本研究纳入30例小儿青光眼患者的30只眼。第1组(15只眼)行羊膜植入联合MMC小梁切除术,第2组(15只眼)仅行MMC小梁切除术。将保存的羊膜置于巩膜瓣上方和结膜下方。术前和术后测量平均眼压(IOP),并记录滤过泡外观。术后随访时间为18个月。

结果

两组术后平均眼压分别显著降至15±1 mmHg和17.2±2.9 mmHg。在随访期间,大多数病例的滤过泡功能良好,但有5例需要再次手术。第1组未发现炎症、脉络膜脱离或中毒性角膜病变等并发症,而第2组有发现。

结论

羊膜移植联合MMC小梁切除术可有效控制小儿青光眼患者升高的眼压,且术后无明显并发症。

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