青光眼小梁切除术中应用平阳霉素与丝裂霉素C的临床对照研究  

A Clinical comparative trial of intraoperative pingyangmycin vs mitomycin C in glaucoma trabeculectomy

作　　者：刘援[1] 石军[1] 朱建莹[1] 李俊英[1] 张海宁[1] 葛方东 白淑芬[1] 

机构地区：[1]淄博康明眼科医院,山东淄博255025

出　　处：《中国实用眼科杂志》2008年第4期327-329,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的评价平阳霉素和丝裂霉素C用于青光眼小梁切除术的临床疗效及其安全性。方法采用临床随机对照试验研究方法，将51例（68只眼）接受小梁切除术的青光眼患者随机分为2组。每组34只眼，术中分别应用0．2mg／ml浓度的平阳霉素或丝裂霉素C棉片巩膜瓣下湿敷，时间均为5min。术后随访时间6～12月，分别观察视力、眼压、角膜内皮细胞密度、滤过泡、术后并发症。结果小梁切除术后1，6，12月，平阳霉素组平均眼压分别为（14．6±5．3）mmHg，（16．3±2．7）mmHg，（18．1±3．3）mmHg；丝裂霉素C组分别为（12．3±3．8）mmHg，（15．1±2．7）mmHg，（17．3±2．7）mmHg，两组间差异无统计学意义。随访观察12个月，平阳霉素组与丝裂霉素C组的累积手术完全成功率分别为78％与77％，累积条件成功率分别为85％与82％，两组之间无显著性差异。手术前后患者的最佳矫正视力与角膜内皮细胞密度变化无显著性差异。手术后的主要的并发症是浅前房、球结膜切口渗漏以及球结膜瓣再次加固缝合，丝裂霉素C组发生这些情况的百分数明显大于平阳霉素组，有显著性差异。结论平阳霉素应用于青光眼小梁切除术可以达到和丝裂霉素C近似的临床效果，并且并发症较丝裂霉素C少，可以安全地应用于眼科临床。Objective To compare the safety and efficacy of intraoperative pingyangmycin and intraoperative mitomycin C in eyes undergoing trabeculectomy. Method 51 glaucoma patients （68 eyes） were randomly assigned to 2 groups. The eyes in pingyangmycin group receive topical pingyangmycin（ 0.2mg/ml for 5 minutes） and eyes in mitomycin C group receive topical mitomycin C （0.2mg/ml for 5 minutes） intraoperatively by soaked sponge. The follow-up times were ranged from 6-12 months. The outcomes measured after operation includes IOP, filtering bleb, visual acuity, corneal endothelial cell density and postoperative complications. Results The average IOP postoperative 1,6,12 month in pingyangmycin group was higher than those in mitomycin C group ,but there were no statistic difference. The 12th month life-table complete and qualified success rates were 78% and 85% in pingyangmycin group, 77% and 82% in mitomycin C group, respectively. The difference of complete and qualified success rates in each group were no statistic difference. There were no statistic difference about preoperative and postoperative best corrective visual vision and the density of corneal endothelium. The most common postoperative complications in each group were shallow anterior chamber,belb leak and restutring the conjunctiva.Conelusion Our study suggests that intraoperative topical pingyangmycin is at least as effective as intraoperative topical mitomycin C in reducing IOP of eyes undergoing trabeculectomy, and there are less postoperative complications in pingyangmycin group.

关 键 词：青光眼 小梁切除术 平阳霉素 丝裂霉素C 

分 类 号：R775.05[医药卫生—眼科] R777.33[医药卫生—临床医学]