Wong J S, Yip L, Tan C, Chew P
Department of Ophthalmology, National University Hospital Singapore and Singapore National Eye Centre, Singapore.
Aust N Z J Ophthalmol. 1998 Nov;26(4):283-8. doi: 10.1111/j.1442-9071.1998.tb01331.x.
To define and compare the trabeculectomy survival with regard to intra-ocular pressure (IOP) control without further surgery or anti-glaucoma medication n an Asian population.
A retrospective review of two consecutive groups of patients who had trabeculectomy surgery in a university eye department setting. The first group of patients (group A) did not receive any adjunctive 5-fluorouracil (5-FU), while the second group (group B) had intra-operative sponge application of 5-FU. Only the first trabeculectomy of patients who had bilateral trabeculectomy and the first trabeculectomy performed in patients who had repeated surgery was analysed. Combined procedures were excluded. Survival analysis was performed using the Kaplan-Meier product limit method.
Eighty-nine patients (51 in group A and 38 in group B) were studied, with a mean follow up of 37.5 and 27.0 months, respectively (P = 0.014). There were no statistical differences in age, gender, mean pretreatment IOP, pre-operative medication, proportion of patients with previous ocular surgery, or proportion of primary compared with secondary glaucoma between the two groups. The probability of trabeculectomy survival (IOP < 22 mmHg without additional medication/surgery) at 12 and 36 months was 54.3 and 36.4%, respectively, in group A and 75.8 and 65.8%, respectively, in group B. The differences in survival were significant (P = 0.006, log rank test).
Our experience with trabeculectomy survival in the Asian population showed poorer success when compared with Caucasian populations reported by other investigators. The survival of trabeculectomy surgery was improved significantly with intra-operative 5-FU. There may be justification for advocating a more liberal use of intra-operative 5-FU in such a population.
在亚洲人群中定义并比较小梁切除术在无需进一步手术或抗青光眼药物治疗情况下控制眼压的成功率。
对在大学眼科接受小梁切除术的两组连续患者进行回顾性研究。第一组患者（A组）未接受任何辅助性5-氟尿嘧啶（5-FU）治疗，而第二组（B组）在术中使用含5-FU的海绵。仅分析接受双侧小梁切除术患者的首次小梁切除术以及接受重复手术患者的首次小梁切除术。排除联合手术。采用Kaplan-Meier乘积限界法进行生存分析。
共研究了89例患者（A组51例，B组38例），平均随访时间分别为37.5个月和27.0个月（P = 0.014）。两组在年龄、性别、术前平均眼压、术前用药、既往眼部手术患者比例或原发性青光眼与继发性青光眼的比例方面无统计学差异。A组小梁切除术成功（眼压<22 mmHg且无需额外药物/手术）的概率在12个月和36个月时分别为54.3%和36.4%，B组分别为75.8%和65.8%。生存差异具有统计学意义（P = 0.006，对数秩检验）。
我们在亚洲人群中进行小梁切除术成功率的经验表明，与其他研究者报道的白种人群相比，成功率较低。术中使用5-FU可显著提高小梁切除术的成功率。在该人群中提倡更广泛地使用术中5-FU可能是合理的。
