5-氟尿嘧啶和丝裂霉素C在Ahmed引流阀治疗新生血管性青光眼中的应用比较  

Efficacy of 5-fluorouracil or mitomycin C combined with Ahmed glaucoma valve implantation for treatment of neovascular glaucoma

作　　者：赵丽君[1] 王亚辰 张立军[1] ZHAO Lijun;WANG Yachen;ZHANG Lijun(Department of Ophthalmology,Dalian Third People’s Hospital,Dalian 116011,China)

机构地区：[1]大连市第三人民医院眼科,辽宁大连116011

出　　处：《中国实用眼科杂志》2018年第5期371-375,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察比较5-氟尿嘧啶(5-fluorouracil,5-FU)和丝裂霉素C(mitomycin C,MMC)在Ahmed青光眼引流阀(AGV)植入术治疗新生血管性青光眼(NVG)中的应用疗效。方法回顾分析2014年11月至2016年12月在我院行AGV治疗NVG患者35例(37只眼),术前均行抗VEGF玻璃体腔注射,待虹膜新生血管消退后行AGV手术,术中使用MMC组17例(18只眼),5-FU组18例(19只眼),术后依据患者屈光介质和眼底原发疾病,给予全视网膜激光光凝(PRP)治疗。观察比较两组患者在术前,术后1 d,1周,1月,3月、6月的眼压和最佳矫正视力以及术后并发症的发生情况。结果丝裂霉素和氟尿嘧啶组术后各时间点平均眼压(IOP)均较术前明显降低,差异有统计学意义(P<0.01),但各时间点两组之间比较差异无统计学意义(P>0.05)。术后6个月手术总成功率为氟尿嘧啶组79%(15/19)、丝裂霉素组88.9%(16/18),两组间成功率差距不大。结论术中应用5-FU同MMC一样,均是治疗新生血管性青光眼的安全有效方法。To evaluate the efficacy of 5-fluorouracil(5-FU)and mitomycin C(MMC)combined with FP-7 Ahmed glaucoma valve(AGV)implantation on the treatment of neovascular glaucoma(NVG).Methods This was a retrospective,comparative case series study.A total of 35 patients(37 eyes)with neovascular glaucoma who underwent AGV implantation from November 2014 to December 2016;18 patients(19 eyes)were used 5-FU and 17 patients(18 eyes)were MMC in the operation.All the patients underwent the intravitreal injection of anti-VEGF and neovascular were faded away before AGV implantation.The panretinaphotocoagnlation(PRP)was performed in the patients with clear ocular media after AGV implantation.Change of intraocular pressure(IOP),the best corrected visual acuity(BCVA)and postoperative complications were followed up at 1 day,1 week,1 month,3 and 6 months in two groups.Results Compared with pre-operation,the mean IOP after operation were significantly decreased(P<0.01).There were no significant differences in IOP in two groups at different time points after operation(P>0.05).Six months after operation,the complete successful rates of operation were 79%(15/19)in 5-FU group and 88.9%(16/18)in MMC group,there was no obvious difference between two groups.Conclusions 5-FU combined with AGV implantation is effective and safe as MMC in the treatment of NVG.

关 键 词：新生血管青光眼 5-FU MMC Ahmed引流阀 

分 类 号：R77[医药卫生—眼科]