Mermoud A, Salmon J F, Murray A D
Department of Ophthalmology, Groote Schuur Hospital, Cape Town, South Africa.
Am J Ophthalmol. 1993 Jul 15;116(1):72-8. doi: 10.1016/s0002-9394(14)71747-7.
The use of one intraoperative application of mitomycin C at the filtration site has been effective in eyes at increased risk for failure of routine trabeculectomy. To study the efficacy and safety of this technique in patients with refractory glaucoma, we prospectively examined 30 eyes of 26 black patients in whom a 0.2-mg/ml solution of mitomycin C was applied between Tenon's capsule and the sclera for five minutes before trabeculectomy. The results were compared to those found in a matched group of 30 eyes of 28 patients who underwent trabeculectomy without mitomycin C. The mean postoperative intraocular pressures were significantly lower in the mitomycin C group than in the control group (P = .001). Of the 30 eyes in the mitomycin C group, 25 (83%) had an intraocular pressure of less than 21 mm Hg without glaucoma medication, compared to 11 of 30 (37%) in the control group (P = .00006). In the mitomycin C group, 19 eyes (63%) developed a cystic avascular thin-walled filtering bleb, four eyes (13%) a late positive Seidel test, and one eye slight scleral thinning over the area where the mitomycin C was applied. Although mitomycin C is effective when used in this manner, further study is required to determine the long-term complications.
在滤过部位术中应用一次丝裂霉素C，对常规小梁切除术失败风险增加的眼睛有效。为研究该技术在难治性青光眼患者中的疗效和安全性，我们前瞻性地检查了26例黑人患者的30只眼睛，在小梁切除术前行将0.2mg/ml丝裂霉素C溶液应用于眼球筋膜囊与巩膜之间5分钟。将结果与28例接受小梁切除术但未使用丝裂霉素C的匹配组患者的30只眼睛的结果进行比较。丝裂霉素C组术后平均眼压显著低于对照组（P = 0.001）。丝裂霉素C组的30只眼中，25只（83%）在未使用青光眼药物的情况下眼压低于21mmHg，而对照组30只眼中有11只（37%）眼压低于21mmHg（P = 0.00006）。在丝裂霉素C组中，19只眼睛（63%）形成了囊性无血管薄壁滤过泡，4只眼睛（13%）出现晚期阳性Seidel试验，1只眼睛在应用丝裂霉素C的区域出现轻微巩膜变薄。虽然以这种方式使用丝裂霉素C是有效的，但需要进一步研究以确定长期并发症。
