针拨联合球结膜下注射丝裂霉素C治疗新生血管性青光眼小梁切除术后功能不良滤过泡  

Needling revision with mitomycin C subconjuctival injection on failed filtering blebs after trabeculectomy for neovascular glaucoma

作　　者：于东珍[1] 刘真[1] 赵梅[1] 高宁[1] 陈雯[1] 刘玉岭[1] 

机构地区：[1]山东省聊城市第二人民医院眼科,252600

出　　处：《临床眼科杂志》2009年第4期343-345,共3页Journal of Clinical Ophthalmology

摘　　要：目的探讨针拨联合丝裂霉素C(MMC)球结膜下注射治疗新生血管青光眼小梁切除术后功能不良滤过泡的疗效。方法对25例(25只眼)因新生青光眼行小梁切除术后滤过泡功能不良者,进行针拨联合MMC0.2 m l(0.04 mg)球结膜下注射,观察视力、眼压、滤过泡和副作用,并随访6～12个月。结果小梁切除术后低平限局肥厚充血型18只眼、包囊型囊样7只眼。针拨联合MMC结膜下注射治疗后6～12个月,轻度膨隆弥散型11只眼,多腔或薄壁型8只眼,限局肥厚型或无滤过泡6只眼。治疗前患眼的眼压为(32.5±5.5)mm Hg,随访结束时具有功能滤过泡眼的眼压为(18.2±3.4)mm Hg。与针拨前比较两者差异有统计学意义(P<0.05)。19只眼眼压下降有效,成功率占75%。治疗后结膜下出血3只眼,前房出血5只眼,无低眼压、伤口渗漏和脉络膜渗漏及浅前房等并发症。结论针拨联合MMC结膜下注射治疗新生血管性青光眼小梁切除术后功能不良滤过泡是安全、有效、简单的方法。Objective To evaluatc the therapcutic effects of needling revision with mitomycin C （ MMC ） subconjuctival injection on failed filtering blebs after trabeculectomy for neovascular glaucoma. Methods Needling revision with MMC 0. 2 mL（0 . 04 mg） subconjuctival injection was performed on 25eyes of 25 patients with failed filtering blebs after trabeculectomy for neovascular glaucoma. The sight , intraocular pressure （ IOP） blebs and side effects were observed, and follow-up was conducted for 6 -12 months. Results There were 18 eyes with thickened and focalized blebs, 7 eyes with encapsulated blebs after trabeculectomy. Six to twelve months after needling revision with MMC subconjuctival injection blebs of 19 eyes turned into functional ones The blebs were diffused and elevated in 11 eyes, thickened and multcysted in 8 eyes, thickened and focalized in 6 eyes, encapsulated, lntraocular pressures （ IOPs ） were significantly （ P 〈 0.05 ） lowered from （32.5 ± 5. 5 ） mm Hg of pre-needling to （ 18.2 ± 3. 4 ）mm Hg of post-needling in 19 functional filtering blebs. There were 19 eyes with IOP 〈 21 mmHg without using anti-glaucoma drug or using one anti-glaucoma drug with the success rate of 75.0%. Subconjunctival hemorrhage occurred in 3 eyes during the needle revision. Hyphema occurred in 5 eyes. No such complications as hypotong wound leaks 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 after trabeculectomy for neovascular glaucoma.

关 键 词：丝裂霉素C 新生血管青光眼 小梁切除术 功能不良滤过泡 

分 类 号：R779.6[医药卫生—眼科]