Department of Ophthalmology, Nottingham University NHS Trust, Queen's Medical Centre, Nottingham NG7 2UH, UK.
Br J Ophthalmol. 2011 Jul;95(7):960-5. doi: 10.1136/bjo.2010.185272. Epub 2010 Dec 16.
BACKGROUND/AIMS: To determine the medium-term intraocular pressure (IOP) control and visual outcomes for patients with advanced glaucoma undergoing trabeculectomy with mitomycin C.
All patients with advanced glaucoma (MD -20 dB or above) undergoing trabeculectomy with mitomycin C between 2000 and 2008 under the care of a single glaucoma surgeon were included. IOP, visual acuity and visual field outcomes were assessed from data prospectively collected into a surgical outcome database.
103 patients were eligible for inclusion. The post-trabeculectomy group mean IOP varied between 11.3 and 13.3 mm Hg between 1 and 7 years. At year 5, 85.2% had an IOP of <16 mm Hg, and 96.3% had an IOP of < 21 mm Hg. The number completing a reliable visual-field exam decreased significantly year on year, but the change in mean MD for the group as a whole and for individual patients remained stable. 28 patients experienced a significant reduction in acuity defined as two or more lines of Snellen, although this was not due to glaucoma surgery in the majority. The only preoperative determinant for a significant reduction in VA was the preoperative MD (-27.00 dB (n=21) compared with -24.79 dB (n=63; p=0.029)).
Trabeculectomy is a successsful method of controlling IOP in the short to medium term in patients with advanced glaucoma.
背景/目的：评估丝裂霉素 C 小梁切除术治疗晚期青光眼患者的中期眼压（IOP）控制和视力结果。
纳入了 2000 年至 2008 年间由一位青光眼外科医生负责的接受丝裂霉素 C 小梁切除术的所有晚期青光眼（MD-20dB 或以上）患者。从前瞻性收集到手术结果数据库中的数据评估 IOP、视力和视野结果。
共有 103 例患者符合纳入标准。术后 1 至 7 年，术后组平均 IOP 在 11.3 至 13.3mm Hg 之间。在第 5 年，85.2%的患者 IOP<16mmHg，96.3%的患者 IOP<21mmHg。完成可靠视野检查的人数逐年显著减少，但作为一个整体和个别患者的平均 MD 变化保持稳定。28 例患者的视力显著下降（定义为两行或更多行 Snellen 视力），尽管这在大多数情况下不是由青光眼手术引起的。VA 显著下降的唯一术前决定因素是术前 MD（-27.00dB（n=21）与-24.79dB（n=63；p=0.029））。
在短期内，丝裂霉素 C 小梁切除术是治疗晚期青光眼患者 IOP 的成功方法。
