Hara T, Shirato S, Miyata N, Eguchi K, Takada M
Department of Ophthalmology, University of Tokyo School of Medicine, Japan.
Nippon Ganka Gakkai Zasshi. 1995 Nov;99(11):1283-8.
We examined the results of postoperative intraocular pressure (IOP) control and complications of trabeculectomy with mitomycin C in open angle glaucoma patients who had not undergone any other ocular surgery. The subjects were 80 eyes of 70 patients who underwent surgery with 0.04% mitomycin C as an adjunct for 3 minutes and were followed for 7-24 months (mean +/- standard deviation: 13 +/- 3.4). The preoperative IOP was 21-32 mmHg (mean +/- standard deviation: 24.6 +/- 4.3) in maximum tolerable medications. IOP control ratio, which was analysed with the Kaplan-Meier method at 24 months after surgery was 81.6% without any antiglaucoma medications, vs 92.0% with medications. These values were significantly higher (p < 0.05) than the results of trabeculectomy with 5-fluorouracil or without antimetabolic agents previously performed in our clinic. Shallow chamber in 18 eyes (23%), choroidal detachment in 14 eyes (18%), hypotonus maculopathy in 7 eyes (9%), and cataract progression in 5 eyes (7%) were recognised as complications. Although there are some complications to be conquered, trabeculectomy with mitomycin C seems to be effective in treating primary open angle glaucoma patients.
我们研究了丝裂霉素C辅助小梁切除术治疗未接受过其他眼科手术的开角型青光眼患者的术后眼压控制结果及并发症。研究对象为70例患者的80只眼，这些患者接受了0.04%丝裂霉素C辅助手术3分钟，并随访7至24个月（平均±标准差：13±3.4）。术前在最大耐受药物治疗下眼压为21至32 mmHg（平均±标准差：24.6±4.3）。术后24个月采用Kaplan-Meier法分析眼压控制率，不用任何抗青光眼药物时为81.6%，使用药物时为92.0%。这些数值显著高于我们诊所之前进行的5-氟尿嘧啶辅助小梁切除术或不使用抗代谢药物的小梁切除术的结果（p<0.05）。并发症包括18只眼（23%）出现浅前房、14只眼（18%）出现脉络膜脱离、7只眼（9%）出现低眼压性黄斑病变以及5只眼（7%）出现白内障进展。尽管仍有一些并发症需要克服，但丝裂霉素C辅助小梁切除术似乎对治疗原发性开角型青光眼患者有效。
