改良小梁切除术联合丝裂霉素C治疗青光眼的临床观察  

Clinical observation of modified trabeculectomy with mitomycin C for the treatment of glaucoma

作　　者：李盈龙[1] 彭小宁[1] 

机构地区：[1]合肥市第一人民医院眼科,合肥230061

出　　处：《中华眼外伤职业眼病杂志》2012年第5期379-382,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨改良式小梁切除术联合丝裂霉素C治疗青光眼的临床疗效。方法应用改良式小梁切除术治疗42例64眼各型青光眼，术中一次性使用0．4mg／ml丝裂霉素C，术后随访6—12月，观察其临床疗效及其并发症。结果术后1个月检查，58眼（90．6％）术后视力有不同程度的提高；术后1周测眼压，所有病例眼压均有不同程度的下降，有48眼（75．0％）眼压低于21mmHg，术后6个月测眼压，54眼（84．4％）低于21mmHg；末次随访时，56眼（87．5％）形成弥散扁平的功能性滤过泡，8眼（12．5％）为非功能性滤过泡；总手术成功58眼（90．6％），其中完全成功54眼（84．4％），条件成功4眼（6．3％），失败6眼（9．4％）。术后主要并发症为：角膜水肿5眼，前房渗出4眼。结论改良小梁切除术联合丝裂霉素C治疗青光眼，可有效地减少青光眼术后滤过道瘢痕的形成，充分降低眼压。该方法不需要特殊设备，手术时间短，损伤小，并发症少，手术效果好，是一种安全、有效的治疗青光眼方法。Objective To explore the clinical efficiency of modified trabeculectomy with mitomycin C （MMC） on glaucoma. Methods 42 cases （64 eyes） with glaucoma received the modified trabeeulectomy, 0.4 mg/ml MMC was used in the operation. The clinical efficiency and complication were conducted. The post-operative follow-up periods ranged from 6 to 12 months. Results At 1 month ,the visual acuity in 58 eyes （90.6%） increased in different le-vels, at 1 week, the IOP of all patients decreased in different levels and 48 eyes（75.0% ） were lower than 21mmHg. At 6 months, the lOP were lower than 21 mm Hg in 54 eyes （84.4%） , there were diffused and fiat functioning blebs in 56 eyes （87.5%） and non-functioning blebs in 8 eyes（ 12.5% ）. 58 eyes （90.6%）had successful operations.54 eyes（84.4% ） without medicine and 4 eyes（6.3% ） with medicine, 6 eyes（9.4% ） failed . The postoperative complications were corneal edema （5 eyes） and anterior chamber fibrin exudation （4 eyes）. Conclusion Modified trabeculectomy with mitomycin C for glaucoma can effectively reduce postoperative scar adhesion of the filtration passage and lower the lOP to a target level. It is a safe and effective treatment for glaucoma, which needs no special equip- ments but shorter time, fewer complications and light damage.

关 键 词：青光眼 小梁切除术改良 丝裂霉素C 

分 类 号：R779.6[医药卫生—眼科]