丝裂霉素C在小梁切除术强化治疗中的安全性和有效性：结膜下注射与海绵应用对比

Safety and Efficacy of Mitomycin C: Augmented Trabeculectomy: Subtenon's Injection versus Sponge Application.

作者信息

Sedani Kanan Vimal, Bhagat Purvi Raj, Chauhan Abhishek Suryakant

机构信息

Department of Ophthalmology, M and J Western Regional Institute of Ophthalmology, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India.

Department of Ophthalmology, Glaucoma Unit, M and J Western Regional Institute of Ophthalmology, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India.

出版信息

Int J Appl Basic Med Res. 2024 Jul-Sep;14(3):156-161. doi: 10.4103/ijabmr.ijabmr_154_24. Epub 2024 Aug 24.

DOI:10.4103/ijabmr.ijabmr_154_24

PMID:39310071

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11412556/

Abstract

OBJECTIVE

The objective of the study was to study the safety and efficacy of subtenon injection of mitomycin C (MMC) versus sponge application of MMC during trabeculectomy.

MATERIALS AND METHODS

Thirty-seven patients having primary glaucoma warranting trabeculectomy were enrolled in the study and their forty eyes were alternately allocated into either of the two groups: subtenon injection (ST) of 0.1 mL of 0.01% of MMC or sponge application (SP) of 0.02% of MMC and were operated by a single surgeon and followed for 3 months. The outcome was analyzed primarily based on reduction in intraocular pressure (IOP) and bleb morphology.

RESULTS

Similar outcome in terms of complete success (ST - 90% and SP - 85%), qualified success (ST - 5% and SP - 5%), and failure rate (ST - 5% and SP - 10%) was seen at the end of 3 months. The absolute reduction in IOP from the baseline was -10.00 ± 3.67 mmHg (-41.2% ± 12.30) in ST versus -8.90 ± 5.56 mmHg (-35.9% ± 16.1) in the SP group at the end of 3 months. At the end of 3 months, blebs in the ST group had low-to-medium height and in the SP group had low height. Blebs in both the groups were diffuse with mild vascularity. Antiglaucoma medications required postoperatively were 0.20 ± 0.62 versus 0.40 ± 1.10 in the ST and SP group, respectively. The duration of surgery was 19.85 ± 0.75 min in the ST group versus 22.50 ± 0.51 min in the SP group.

CONCLUSION

Subtenon injection of MMC is as efficacious and safe as the conventional sponge application technique.

摘要

目的

本研究的目的是比较小梁切除术期间球结膜下注射丝裂霉素C（MMC）与丝裂霉素C海绵应用的安全性和有效性。

材料与方法

37例需要进行小梁切除术的原发性青光眼患者纳入本研究，他们的40只眼睛被交替分配到两组中的任意一组：0.1 mL 0.01%的MMC球结膜下注射（ST）组或0.02%的MMC海绵应用（SP）组，由同一位外科医生进行手术，并随访3个月。主要根据眼压（IOP）降低情况和滤过泡形态分析结果。

结果

3个月末，两组在完全成功率（ST组-90%，SP组-85%）、合格成功率（ST组-5%，SP组-5%）和失败率（ST组-5%，SP组-10%）方面的结果相似。3个月末，ST组眼压从基线的绝对降低值为-10.00±3.67 mmHg（-41.2%±12.30），而SP组为-8.90±5.56 mmHg（-35.9%±16.1）。3个月末，ST组的滤过泡高度为低到中等，SP组的滤过泡高度较低。两组的滤过泡均为弥漫性，血管化程度较轻。ST组和SP组术后所需的抗青光眼药物分别为0.20±0.62和0.40±1.10。ST组的手术时间为19.85±0.75分钟，而SP组为22.50±0.51分钟。