尼日利亚5-氟尿嘧啶辅助小梁切除术的长期疗效

LONG TERM OUTCOMES OF AUGMENTED TRABECULECTOMY WITH 5-FLUOROURACIL IN NIGERIA.

作者信息

Olawoye O O, Ashaye A O

机构信息

Department of Ophthalmology, College of Medicine University of Ibadan, Ibadan, Nigeria.

出版信息

J West Afr Coll Surg. 2017 Jan-Mar;7(1):92-112.

PMID:29951457

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6018030/

Abstract

BACKGROUND

Glaucoma in sub-Saharan Africa has been described as a surgical disease because of the high cost of medical treatment, poor compliance and unavailability of medications.

AIM

This study reports the long-term outcomes and complication rates following trabeculectomy with 5-fluorouracil in a case series of Nigerians.

DESIGN OF STUDY

This was a retrospective, observational, non-comparative case series.

SETTING

University College Hospital, Ibadan, Nigeria.

METHODOLOGY

Each patient had complete ophthalmic evaluation. The post-operative intraocular pressure (IOP), visual acuity outcomes and post operative complications were assessed. The World Glaucoma Association consensus on surgical outcome was used to evaluate surgical outcome.

RESULTS

Of the 292 patients who presented with glaucoma during this period, a total of 47 eyes of 31 patients (10.6%) had trabeculectomy with 5-FU. The mean presenting intraocular pressure (IOP) was 31.8±12.2mmHg. At three years post-operatively, 48.5% achieved complete success without medications while 90.9% achieved success with or without medications at an IOP cut off of ≤21mmHg. At the same time point of 3 years and an IOP cut off of ≤15mmHg, 63.6% achieved success with or without medications. At a mean post-operative period of 43± 19.6 months, (range 12-86 months), mean IOP had reduced from a preoperative mean of 31.8±12.2mmHg to 15.4±4.7mmHg (P<0.001).

CONCLUSION

Trabeculectomy with 5-Fluorouracil is effective in the long term in reducing IOP with minimal complications in this population of Nigerians.

摘要

背景

由于医疗费用高昂、依从性差以及药物供应不足，撒哈拉以南非洲地区的青光眼被描述为一种需手术治疗的疾病。

目的

本研究报告了尼日利亚一系列病例中行小梁切除术联合5-氟尿嘧啶治疗后的长期疗效和并发症发生率。

研究设计

这是一项回顾性、观察性、非对照病例系列研究。

研究地点

尼日利亚伊巴丹大学学院医院。

方法

对每位患者进行全面的眼科评估。评估术后眼压（IOP）、视力结果及术后并发症。采用世界青光眼协会关于手术结果的共识来评估手术效果。

结果

在此期间出现青光眼的292例患者中，共有31例患者（10.6%）的47只眼接受了小梁切除术联合5-氟尿嘧啶治疗。初始眼压平均为31.8±12.2mmHg。术后三年，48.5%的患者在未使用药物的情况下取得了完全成功，而在眼压≤21mmHg时，90.9%的患者无论是否使用药物均取得了成功。在三年的同一时间点且眼压≤15mmHg时，63.6%的患者无论是否使用药物均取得了成功。在平均术后43±19.6个月（范围12 - 86个月）时，眼压均值从术前的31.8±12.2mmHg降至15.4±4.7mmHg（P<0.001）。