摘要
目的探讨针拨联合丝裂霉素C（mitomycin C,MMC）结膜下注射治疗青光眼小梁切除术后早期功能不良滤过泡的疗效。方法对76例（86眼）因青光眼行标准小梁切除术后2~6周滤过泡功能不良者,进行针拨联合MMC0.2 mL（0.04 mg）结膜下注射,平均治疗1.88次,观察眼压、滤过泡和副作用,并随访6个月。结果小梁切除术后2~6周,低平肥厚充血型滤过泡50眼,包裹型滤过泡32眼,无滤过泡4眼。针拨联合MMC结膜下注射治疗后6个月,61眼变为功能性滤过泡,其中微囊状泡24眼,平坦弥散型37眼 无滤过泡6眼 低平肥厚滤过泡6眼 包裹型滤过泡13眼。治疗后3个月时平均眼压（15.2±6.1）mmHg,57眼降压显效,17眼降压有效,总有效率为86.1% 治疗后6月时平均眼压（15.7±6.7）mmHg,51眼降压显效,17眼降压有效,总有效率为79.1%。结膜下出血21眼,无前房变浅或低眼压、伤口渗漏和脉络膜渗漏等并发症。结论针拨联合MMC结膜下注射治疗小梁切除术后早期功能不良滤过泡是安全、有效、简单的方法。
Objective To evaluate the therapeutic effects of needling revision with mitomycin C （MMC） subconjuctival injection on early failed filtering blebs after trabeculectomy for glaucoma. Methods Needling revision with MMC 0.2 mL （0.04 mg） subconjuctival injection was performed on 86 eyes of 76 patients with failed filtering blebs 2 to 6 weeks after trabeculectomy for glaucoma. An average of 1.88 times of treatment was performed. The intraocular pressure （IOP） , blebs and side effects were observed, and follow-up was conducted for 6 months. Results Two to six weeks after trabeculectomy, there were 50 eyes with thickened and focalized blebs, 32 eyes with encapsulated blebs and 4 eyes with no bleb. Six months after needling revision with MMC subconjuctival injection, blebs of 61 eyes turned into functional ones. The blebs were thinned and multicysted in 24 eyes, diffused and elevated in 37 eyes, thickened and focalized in 6 eyes, encapsulated in 13 eyes and disappeared in 6 eyes. Three months after treatment, the mean IOP was （15.2±6.1） mmHg, and there were 57 eyes with IOP 〈 21 mmHg without using anti-glaucoma drug and 17 eyes with IOP 〈 21 mmHg using one antiglaucoma drug, with the success rate of 86.1%. Six months after treatment, the mean IOP was （15.7 ± 6.7） mmHg, and there were 51 eyes with IOP 〈21 mmHg without using antilaucoma drug and 17 eyes with lOP 〈21 mmHg using one antiglaucoma drug, with the success rate of 79.1%. Subconjuctiva hemorrhage occurred in 21 eyes. No such complications as hypotony, choroidal effusion and shallow anterior chamber were observed during the follow up. Conclusion Needling revision with MMC subconjuctival injection is an effective, safe and simple method for failed filtering blebs early after trabeculectomy.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2008年第6期707-709,共3页
Journal of Shanghai Jiao tong University:Medical Science
