Menda Shivali A, Lowry Eugene A, Porco Travis C, Stamper Robert L, Rubin Michel R, Han Ying
Department of Ophthalmology, University of California San Francisco, 10 Koret Way, San Francisco, CA, 94143, USA.
Int Ophthalmol. 2015 Jun;35(3):357-63. doi: 10.1007/s10792-014-9955-3. Epub 2014 Jun 12.
To compare the complication rate and effectiveness of mitomycin C (MMC), Ologen alone, and Ologen with 5-fluorouracil (5-FU) as adjunctives with Ex-PRESS mini shunt for medically uncontrolled glaucoma. Retrospective comparative study of 59 Ex-PRESS mini shunt trabeculectomy operations coupled with Ologen implantation alone, transient MMC application or Ologen implantation with 5-FU as adjunctive treatment. Eight eyes (7 patients) received Ologen alone, 37 eyes (34 patients) received MMC, and 14 eyes (14 patients) received Ologen with 5-FU as adjunctive therapy. Baseline characteristics, adjunctive used during operation, along with outcomes including intraocular pressure (IOP), number of anti-hypertensive drops, visual acuity, and complications were documented and compared. The primary outcome was IOP at 12 months. Variables were compared with r × c Fisher tests. The Ologen only group had a significantly higher IOP at 12 months (20.5 ± 10.23 mmHg) compared with Ologen combined with 5-FU (12.2 ± 1.47 mmHg) or MMC (13.8 ± 4.37 mmHg) (p = 0.015, linear mixed model). The Ologen only cohort also had a higher re-operation rate (p = 0.01, Fisher's Exact Test) and higher rate of bleb leak (p = 0.02, Fisher's Exact Test). Visual acuity was similar among all three groups. 5-FU with Ologen is as effective as MMC in maintaining IOP following Ex-PRESS shunt surgery at 1 year. However, Ologen alone may not be as effective as the other two adjunctive agents.
比较丝裂霉素C（MMC）、单独使用Ologen以及Ologen联合5-氟尿嘧啶（5-FU）作为辅助药物与Ex-PRESS微型分流器联合用于药物治疗无法控制的青光眼时的并发症发生率和有效性。对59例Ex-PRESS微型分流小梁切除术联合单独植入Ologen、短暂应用MMC或Ologen联合5-FU作为辅助治疗进行回顾性比较研究。8只眼（7例患者）单独接受Ologen，37只眼（34例患者）接受MMC，14只眼（14例患者）接受Ologen联合5-FU作为辅助治疗。记录并比较基线特征、手术中使用的辅助药物以及包括眼压（IOP）、降压眼药水使用次数、视力和并发症在内的结果。主要结局是12个月时的眼压。变量通过r×c Fisher检验进行比较。与Ologen联合5-FU（12.2±1.47 mmHg）或MMC（13.8±4.37 mmHg）相比，仅使用Ologen的组在12个月时眼压显著更高（20.5±10.23 mmHg）（p = 0.015，线性混合模型）。仅使用Ologen的队列再手术率也更高（p = 0.01，Fisher精确检验），滤过泡渗漏率更高（p = 0.02，Fisher精确检验）。三组之间视力相似。在Ex-PRESS分流术后1年，Ologen联合5-FU在维持眼压方面与MMC一样有效。然而，单独使用Ologen可能不如其他两种辅助药物有效。
