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巩膜隧道切开术联合胶原基质植入物(Ologen)和低浓度丝裂霉素 C 行小梁切除术和前房内小梁切除术的疗效:2 年随访。

Outcomes of Trabeculectomy and Phacotrabeculectomy With Collagen Matrix Implant (Ologen) and Low-dose Mitomycin C: 2-Year Follow-up.

机构信息

Ophthalmology Department, Universitary Hospital Príncipe de Asturias.

School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain.

出版信息

J Glaucoma. 2018 Jan;27(1):50-54. doi: 10.1097/IJG.0000000000000818.

Abstract

PURPOSE

The purpose of this article is to analyze the results achieved in lowering intraocular pressure (IOP) after trabeculectomy or combined surgery (phacotrabeculectomy) with low-dose mitomycin C (MMC) using the Ologen Collagen Matrix (Ologen CM) implant.

MATERIALS AND METHODS

This retrospective study included 58 eyes from 47 consecutive patients with glaucoma who underwent filtering surgery alone or combined with cataract surgery. The study group included 29 eyes that underwent trabeculectomy (14 eyes) or phacotrabeculectomy (15 eyes) with low-dose MMC (0.1 mg/mL×1 min) and subconjunctival Ologen CM implant at the end of surgery. The control group included 29 eyes, 12 that underwent trabeculectomy and 17 that underwent phacotrabeculectomy, with the same MMC dose but without the collagen matrix implant. All surgical procedures were performed by the same surgeon. The follow-up period for the patients was 2 years.

RESULTS

We found statistically significant differences between the 2 groups in the age of the patients (P=0.02). We found no statistically significant differences in the baseline IOP (P=0.37) or preoperative IOP (P=0.5), nor in the visual field damage measured with mean deviation (P=0.2). The number of hypotensive medications used preoperatively was higher in the study group (P=0.0001). At 1 and 2 years after surgery, we only found statistically significant differences in favor of the study group in patients who underwent phacotrabeculectomy (P=0.0008 and 0.02, respectivily).

CONCLUSION

The Ologen CM implant can be considered as an adjunct to MMC in patients undergoing filtering surgery combined with phacoemulsification to improve postoperative IOP results over the long term.

摘要

目的

本文旨在分析在滤过性手术中联合应用低剂量丝裂霉素 C(MMC)和 Ologen 胶原基质(Ologen CM)植入物,对小梁切除术或联合手术(超声乳化白内障吸除术联合小梁切除术)降低眼内压(IOP)的效果。

材料与方法

本回顾性研究共纳入 47 例连续患者的 58 只眼,这些患者均患有青光眼,接受了单纯滤过性手术或联合白内障手术。研究组包括 29 只眼,这些眼在手术结束时接受了低剂量 MMC(0.1mg/ml×1min)和结膜下 Ologen CM 植入物的小梁切除术(14 只眼)或超声乳化白内障吸除术联合小梁切除术(15 只眼)。对照组包括 29 只眼,其中 12 只眼接受了小梁切除术,17 只眼接受了超声乳化白内障吸除术联合小梁切除术,MMC 剂量相同,但未使用胶原基质植入物。所有手术均由同一位外科医生进行。患者的随访时间为 2 年。

结果

我们发现,两组患者的年龄存在统计学显著差异(P=0.02)。两组患者的基础眼压(P=0.37)或术前眼压(P=0.5)、平均偏差测量的视野损害均无统计学显著差异。研究组术前使用降眼压药物的数量更多(P=0.0001)。术后 1 年和 2 年,仅在接受超声乳化白内障吸除术联合小梁切除术的患者中,我们发现研究组具有统计学显著优势(分别为 P=0.0008 和 0.02)。

结论

Ologen CM 植入物可被视为在滤过性手术中联合应用超声乳化白内障吸除术时,辅助 MMC 应用的方法,以改善长期术后 IOP 结果。

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