Nuyts R M, Greve E L, Geijssen H C, Langerhorst C T
Department of Ophthalmology, University of Amsterdam, The Netherlands.
Am J Ophthalmol. 1994 Sep 15;118(3):322-31. doi: 10.1016/s0002-9394(14)72956-3.
We treated 34 eyes of 32 patients who developed a hypotonous maculopathy after a trabeculectomy with mitomycin C with various treatment strategies. Placement of a Megasoft Bandage Contact Lens in 24 eyes did not result in a notable increase in intraocular pressure or visual acuity. Intrableb injection of autologous blood in 22 eyes resulted in a mean +/- standard deviation (S.D.) increase in intraocular pressure from 4.3 +/- 1.8 mm Hg before injection to 8.6 +/- 4.6 mm Hg after injection. Mean logMAR visual acuity improved from 0.71 +/- 0.40 to 0.32 +/- 0.25. After a surgical revision of 16 eyes, intraocular pressure increased from 4.1 +/- 1.9 mm Hg to 11.3 +/- 4.0 mm Hg, and logMAR visual acuity improved from 0.61 +/- 0.30 to 0.22 +/- 0.24. At the last follow-up examination (12.2 +/- 5.1 months after the trabeculectomy), 31 eyes (91.2%) had an intraocular pressure greater than 6 mm Hg. Hypotonous maculopathy after trabeculectomy with mitomycin C can be treated successfully by autologous blood injection and surgical revision of the filtration site.
我们采用多种治疗策略，对32例小梁切除术联合丝裂霉素C后发生低眼压性黄斑病变的患者的34只眼进行了治疗。24只眼佩戴Megasoft绷带接触镜后，眼压和视力均未显著提高。22只眼行巩膜下自体血注射后，眼压平均升高（±标准差），从注射前的4.3±1.8 mmHg升至注射后的8.6±4.6 mmHg。平均logMAR视力从0.71±0.40提高到0.32±0.25。16只眼行手术修复后，眼压从4.1±1.9 mmHg升至11.3±4.0 mmHg，logMAR视力从0.61±0.30提高到0.22±0.24。在最后一次随访检查时（小梁切除术后12.2±5.1个月），31只眼（91.2%）眼压高于6 mmHg。小梁切除术联合丝裂霉素C后发生的低眼压性黄斑病变可通过自体血注射和滤过部位的手术修复成功治疗。
