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青光眼瘘管手术中瘢痕调节剂概述。

Overview of cicatricial modulators in glaucoma fistulizing surgery.

机构信息

Faculdade de Medicina, Unichristus, Fortaleza, Ceará, Brazil.

出版信息

Int Ophthalmol. 2020 Oct;40(10):2789-2796. doi: 10.1007/s10792-020-01454-w. Epub 2020 Jun 5.

Abstract

INTRODUCTION

Trabeculectomy is the most commonly performed surgery for the definitive treatment of glaucoma. Despite its high resolvability, the postoperative period requires high caution so that excessive filtration or scarring does not occur. This paper aimed to research alternative options to those most used as healing modulators, mitomycin C (MMC) and 5-fluorouracil, commonly associated with complications.

METHODS

This systematic review used the PubMed and SciELO databases, covering publications from 1972 to 2019.

RESULTS

A total of 31 substances and methods were analyzed.

CONCLUSION

Some, such as anti-VEGF, glucocorticoids and betatherapy, did not show results statistically superior to those of MMC. Others, such as the enzyme α5β1-integrin and Ologen, demonstrated efficacy and safety at least similar to that of this drug. In conclusion, further research is still needed for drugs that lead to the same results as mitomycin, but with fewer side effects. More recent studies have focused on technologies that increase communication between target tissues and antifibrotic molecules at the cellular level, being a promising bet for the future.

摘要

简介

小梁切除术是治疗青光眼的最常用手术。尽管其解决率很高,但术后阶段需要高度谨慎,以防止过度滤过或瘢痕形成。本文旨在研究替代最常用于愈合调节剂(丝裂霉素 C [MMC] 和 5-氟尿嘧啶)的选择方案,这些药物通常与并发症相关。

方法

本系统评价使用了 PubMed 和 SciELO 数据库,涵盖了 1972 年至 2019 年的出版物。

结果

共分析了 31 种物质和方法。

结论

一些物质,如抗 VEGF、皮质类固醇和贝塔疗法,其结果并不优于 MMC。其他物质,如酶 α5β1-整联蛋白和 Ologen,其疗效和安全性至少与该药物相似。总之,仍需要进一步研究能够达到与丝裂霉素相同效果但副作用较少的药物。最近的研究更多地集中在能够增加目标组织与细胞水平上抗纤维化分子之间的通信的技术上,这是未来的一个有希望的选择。

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