Figueiredo R S, Araujo S V, Cohen E J, Rapuano C J, Katz L J, Wilson R P
Cornea Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Ophthalmic Surg Lasers. 1996 Nov;27(11):903-9.
The management of coexistent corneal disease and uncontrolled glaucoma continues to be a challenging clinical situation. The purpose of this study is to evaluate the results of combined penetrating keratoplasty and trabeculectomy with mitomycin-C.
A retrospective study was undertaken to review the records of nine patients who had corneal edema and high intraocular pressure managed by simultaneous penetrating keratoplasty and trabeculectomy with mitomycin-C.
The nine patients had an average pre-operative intraocular pressure of 26 mm Hg (range 17 to 41 mm Hg) and associated corneal edema. The average postoperative intraocular pressure at last follow-up was 19 mm Hg (range 5 to 53 mm Hg). Three patients needed additional procedures. Six of nine patients had intraocular pressures judged to be adequately controlled (11 +/- 5 mm Hg, range 5 to 18 mm Hg) throughout the postoperative period (average follow-up 16 months). Grafts remained clear in seven patients. The grafts failed in two cases in which additional glaucoma surgery was necessary.
Combined penetrating keratoplasty and trabeculectomy with mitomycin-C should be considered for selected patients with uncontrolled glaucoma and corneal disease who have sufficient conjunctiva for a filtering procedure.
并存角膜疾病和未控制的青光眼的治疗仍然是具有挑战性的临床情况。本研究的目的是评估穿透性角膜移植术联合丝裂霉素C小梁切除术的效果。
进行一项回顾性研究，以回顾9例因角膜水肿和高眼压而接受穿透性角膜移植术联合丝裂霉素C小梁切除术治疗的患者的记录。
这9例患者术前平均眼压为26 mmHg（范围17至41 mmHg），伴有角膜水肿。末次随访时术后平均眼压为19 mmHg（范围5至53 mmHg）。3例患者需要额外的手术。9例患者中有6例在术后整个时期（平均随访16个月）眼压被判定得到充分控制（11±5 mmHg，范围5至18 mmHg）。7例患者的植片保持透明。2例患者的植片失败，需要进行额外的青光眼手术。
对于患有未控制的青光眼和角膜疾病且有足够结膜用于滤过手术的特定患者，应考虑穿透性角膜移植术联合丝裂霉素C小梁切除术。
