Cheung J C, Wright M M, Murali S, Pederson J E
Department of Ophthalmology, University of Minnesota, Minneapolis 55455, USA.
Ophthalmology. 1997 Jan;104(1):143-9. doi: 10.1016/s0161-6420(97)30347-9.
Trabeculectomy with adjunctive mitomycin C is associated with high success rates in studies with follow-up of less than 1 year. This report evaluates the visual and intraocular pressure (IOP) outcome in eyes after trabeculectomy with adjunctive mitomycin C 1 to 3 years after surgery in a predominantly white group (98.1%).
The records of 157 eyes of 157 consecutive patients, aged 18 or older, who underwent mitomycin C trabeculectomies for uncontrolled glaucoma of various causes were reviewed. All surgeries were performed between April 1991 and June 1993. The concentration of mitomycin C varied from 0.2 to 0.5 mg/ml and was applied for 30 seconds to 5 minutes (only one patient received 0.2 mg/ml). Of the 157 eyes, 110 eyes were at high risk for failure (previous surgeries or inflammatory glaucoma). Thirty-nine eyes had preoperative IOP < or = 21 mmHg.
The mean preoperative IOP was 29.4 +/- 10.3 mmHg. This was reduced to 13.0 +/- 7.6 mmHg at 1 year, 11.5 +/- 6.4 mmHg at 2 years, and 13.4 +/- 7.3 mmHg at 3 years. Cumulative survival rate by life-table analysis was 94.2% +/- 1.9% at 1 year, 92.1% +/- 2.4% at 2 years, and 88.7% +/- 4.0% at 3 years, where failure was defined as reoperation for control of IOP. Complications included cataract formation-progression (n = 31), hyphema (n = 26), choroidal detachment (n = 21), hypotony maculopathy (n = 5), and endophthalmitis (n = 2). Vision deteriorated in 29 eyes and improved by 2 or more Snellen visual acuity lines in 29 eyes.
The IOP reduction after mitomycin C filtering surgery is sustained in the intermediate-term, 1 to 3 years, follow-up period.
在随访时间不足1年的研究中，丝裂霉素C辅助小梁切除术成功率较高。本报告评估了在以白人为主（98.1%）的患者群体中，丝裂霉素C辅助小梁切除术后1至3年的视力和眼压（IOP）结果。
回顾了157例连续患者（年龄18岁及以上）的157只眼睛的记录，这些患者因各种原因导致的青光眼无法控制而接受了丝裂霉素C小梁切除术。所有手术均在1991年4月至1993年6月期间进行。丝裂霉素C的浓度在0.2至0.5mg/ml之间，应用时间为30秒至5分钟（仅1例患者接受0.2mg/ml）。157只眼中，110只眼存在高失败风险（既往手术或炎症性青光眼）。39只眼术前眼压≤21mmHg。
术前平均眼压为29.4±10.3mmHg。术后1年降至13.0±7.6mmHg，2年降至11.5±6.4mmHg，3年降至13.4±7.3mmHg。通过寿命表分析，1年时累积生存率为94.2%±1.9%，2年时为92.1%±2.4%，3年时为88.7%±4.0%，失败定义为因眼压控制而再次手术。并发症包括白内障形成 - 进展（n = 31）、前房积血（n = 26）、脉络膜脱离（n = 21）、低眼压性黄斑病变（n = 5）和眼内炎（n = 2）。29只眼视力下降，29只眼视力提高了2行或更多Snellen视力表行数。
在1至3年的中期随访期内，丝裂霉素C滤过手术后眼压降低效果持续存在。
