Keorochana Narumon, Kunasuntiwarakul Sutheera, Treesit Isaraporn, Choontanom Raveewan
Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand.
Clin Ophthalmol. 2017 Nov 21;11:2057-2063. doi: 10.2147/OPTH.S145957. eCollection 2017.
The aim of this study was to evaluate the efficacy and safety of preoperative posterior subtenon injection of triamcinolone acetonide (PSTA) in noninfectious uveitic patients with secondary glaucoma undergoing primary trabeculectomy with mitomycin C.
This was a retrospective study.
We reviewed the medical records of 10 noninfectious uveitic patients, who had received a single preoperative PSTA 40 mg/1 mL, with secondary glaucoma undergoing primary trabeculectomy with mitomycin C. We collected data before and after surgery on intraocular pressure (IOP), anterior chamber (AC) cells, best-corrected visual acuity (BCVA), morphologic characteristics of the filtering bleb and complications.
The mean time between injection and surgery was 7.8±3.88 days. Postoperative IOP level was significantly lower than preoperative level (31.3±11.44 mmHg) at all visits (<0.02). Antiglaucoma medications were decreased from preoperative (4.9±0.88) to 12-month postoperative (0.8±1.31; -value <0.001) and also discontinued in seven eyes (70%). About 12 months after surgery, eight eyes (80%) with qualified success and two eyes (20%) with failed treatment were recorded. AC cells and BCVA did not differ significantly from baseline; however, all inflammations were controlled successfully. Most desirable bleb morphology was shown at 12 months as well. Complications were blepharoptosis and hypotony maculopathy in two eyes (20%).
A preoperative PSTA may be an effective and safe option in controlling intraocular inflammation and maintaining bleb function after trabeculectomy in noninfectious uveitic patients with secondary glaucoma during a 12-month period.
本研究旨在评估术前球后注射曲安奈德（PSTA）对非感染性葡萄膜炎继发青光眼患者行丝裂霉素C辅助原发性小梁切除术的疗效和安全性。
这是一项回顾性研究。
我们回顾了10例非感染性葡萄膜炎患者的病历，这些患者术前接受了一次40mg/1mL的PSTA注射，继发青光眼并接受了丝裂霉素C辅助原发性小梁切除术。我们收集了手术前后的眼压（IOP）、前房（AC）细胞、最佳矫正视力（BCVA）、滤过泡形态特征和并发症的数据。
注射与手术之间的平均时间为7.8±3.88天。术后各随访时间点的眼压水平均显著低于术前水平（31.3±11.44mmHg）（<0.02）。抗青光眼药物从术前的（4.9±0.88）种减少到术后12个月的（0.8±1.31）种（P值<0.001），且7只眼（70%）停药。术后约12个月，记录到8只眼（80%）手术成功，2只眼（20%）治疗失败。AC细胞和BCVA与基线相比无显著差异；然而，所有炎症均得到成功控制。12个月时也显示出最理想的滤过泡形态。并发症为2只眼（20%）出现上睑下垂和黄斑部低眼压。
术前PSTA可能是控制非感染性葡萄膜炎继发青光眼患者小梁切除术后眼内炎症和维持滤过泡功能12个月的有效且安全的选择。
