Mehel E, Weber M, Stork L, Péchereau A
Department of Ophthalmology, Centre Hospitalo-Universitaire de Nantes, France.
J Ocul Pharmacol Ther. 1998 Dec;14(6):491-6. doi: 10.1089/jop.1998.14.491.
The use of a sponge impregnated with mitomycin-C is an increasingly common practice in glaucoma surgery. The appropriate antibiotic concentration and exposure time have been considered in the literature, but not the exact amount to be used or the size of the sponge. The purpose of this study was to estimate the quantity of mitomycin-C contained in sponges prepared by different surgeons as compared to that in applicators of the type used in Schirmer's test graduation (5 x 5 mm). Four surgeons each cut and prepared 10 sponges for intraoperative use according to their usual method. The same procedure was performed with 10 Schirmer's test graduations. Each sponge and each graduation was immersed in a solution of mitomycin-C 0.2 mg/ml, and the quantity of antibiotic (microg) in each was calculated as the difference between wet and dry weight. The mean quantity (+/- SEM) of mitomycin-C contained in cut sponges was 9.6 +/- 4.4 microg (range 1.9-17.3), and the differences between surgeons were statistically significant (p<0.0001). The mean quantity of antibiotic in Schirmer's test graduation was 1.7 +/- 0.3 microg (range 1.1-2.5), and the differences between surgeons were not statistically significant (p=0.79). The quantities of mitomycin-C contained in sponges prepared for glaucoma surgery differed for a given surgeon and between surgeons. Thus, variations in the doses applied to the sclera could account for certain complications due to mitomycin-C. The use of a Schirmer's test graduation improves predictability for the quantity of mitomycin-C applied to the sclera.
在青光眼手术中，使用浸渍有丝裂霉素-C的海绵越来越普遍。文献中已经考虑了适当的抗生素浓度和暴露时间，但未考虑具体使用量或海绵的大小。本研究的目的是估计不同外科医生制备的海绵中所含丝裂霉素-C的量，并与用于泪液分泌试验刻度条（5×5毫米）的涂抹器中的量进行比较。四位外科医生每人按照其常用方法切割并制备10块海绵用于术中使用。对10个泪液分泌试验刻度条进行同样的操作。将每块海绵和每个刻度条浸入0.2毫克/毫升的丝裂霉素-C溶液中，通过湿重与干重之差计算每块中的抗生素量（微克）。切割后的海绵中所含丝裂霉素-C的平均量（±标准误）为9.6±4.4微克（范围1.9 - 17.3），外科医生之间的差异具有统计学意义（p<0.0001）。泪液分泌试验刻度条中抗生素的平均量为1.7±0.3微克（范围1.1 - 2.5），外科医生之间的差异无统计学意义（p = 0.79）。为青光眼手术制备的海绵中所含丝裂霉素-C的量在特定外科医生之间以及不同外科医生之间存在差异。因此，应用于巩膜的剂量变化可能是丝裂霉素-C导致某些并发症的原因。使用泪液分泌试验刻度条可提高应用于巩膜的丝裂霉素-C量的可预测性。
