丝裂霉素 C 在正常眼压性青光眼深层巩膜切除术中的应用

摘要

·AlM:To study the clinical effect and influence of using mitomycin C for the treatment of normal tension glaucoma in deep sclerectomy. n ·METHODS:Sixty cases (60 eyes) in our treated patients with normal-tension glaucoma from December, 2011 to December, 2012 were refered to all ineffective medication or refusing drug treatment.All patients were randomly divided into two groups.Each group had 30 cases ( 30 eyes ) . Thirty cases of patients with deep sclerectomy were treated as control group, and another 30 patients were used mitomycin C treatment as the observation group on the basis of the above. n ·RESULTS: The average visual acuity of the patients of observation group after operation was significantly improved better than that of the control group (P<0.05). Functional filtering bleb formation and anterior chamber formation proportion of the patients of the observation group were higher than those of control group (P<0.05). After 3mo, postoperative vision field was narrowed in 1 eye ( 3%) of observation group and 4 eyes ( 17%) in control group, with statistical significance (P<0.05).After 3mo, 3 eyes’vision field of observation group ( 10%) became narrow, and 8 eyes (27%) in the control group (P<0.05).The postoperative Long-term recurrence rate of observation group was 7%, obviously lower than that of control group ( 17%) ( P <0.05 ). The postoperative recurrence rate of the observation group after follow-up of 1a was only 3%and significantly lower than 13%of the control group ( P<0.05) . n · CONCLUSlON: Patients with normal tension glaucoma are given deep sclerectomy, combined with mitomycin C for treatment, and the effect is obvious, high safety, low incidence of postoperative complications, low recurrence rate, worthy of clinical application and promotion.%目的：研究深层巩膜切除术中应用丝裂霉素C对于治疗正常眼压性青光眼的临床效果及影响。n　　方法：选取我院2011－12／2013－12期间收治的正常眼压性青光眼患者60例60眼，均为药物治疗效果不佳或拒绝药物治疗的患者。将所有患者随机分为两组各30例30眼。其中30例患者使用深层巩膜切除术进行治疗作为对照组，另30例患者在上述基础上使用丝裂霉素C进行治疗作为观察组。n　　结果：两组患者术后发现，观察组患者平均视力明显提高，好于对照组患者（P＜0．05）。而观察组患者功能型滤过泡形成以及前房形成人数比例明显高于对照组（P＜0．05）。术后3mo 视野变窄观察组1眼（3％），对照组4眼（17％），差异有统计学意义（P＜0．05）。术后3mo视野变窄观察组3眼（10％），对照组8眼（27％），差异有统计学意义（P＜0．05）。观察组术后远期并发症发生率为7％，明显低于对照组的17％（ P＜0．05）。术后随访1a发现，观察组复发率仅为3％，明显低于对照组的13％（ P＜0．05）。结论：正常眼压性青光眼患者在行深层巩膜切除术时，联合丝裂霉素C进行治疗，其效果显著，安全性高，术后并发症发生率低，复发率低，值得临床应用及推广。