Intraoperative Injection vs Sponge-applied Mitomycin C during Trabeculectomy: One-year Study.
Intraoperative Injection vs Sponge-applied Mitomycin C during Trabeculectomy: One-year Study.
复制标题
DOI：
10.5005/jp-journals-10028-1233
复制
发表时间：
2017-09
影响因子：
--
通讯作者：
Y Huang L
中科院分区：
文献类型：
--
作者：
S Khouri A;Huang G;Y Huang L
确定小梁切除术中术中注射丝裂霉素C（MMC）与传统海绵应用MMC相比的安全性和有效性。本研究是一项回顾性比较病例系列研究。30眼原发性开角型青光眼行连续小梁切除术联合MMC注射（注射组），30眼海绵贴敷MMC作为对照（海绵组）。在术前和术后1天、1周、1个月、3个月、6个月和1年收集数据。记录人口统计学数据、压平眼内压（IOP）、最佳矫正视力（VA）、青光眼药物治疗次数、术后干预、术后并发症和3个月内就诊次数。为了对数据进行分层，计算在使用或不使用青光眼药物的情况下实现IOP从基线降低>30%的眼睛的比例，并将其定义为手术成功。注射组和海绵组1年时的平均IOP较基线均显著降低（分别为46.8%和37.8%）。注射组的术后IOP总体较低，完全治疗成功率相当，定义为在不使用青光眼药物的情况下IOP降低>30%（p = 0.941）。注射组3个月内的术后访视次数和需要5-氟尿嘧啶（5-FU）干预的患眼比例显著较低（分别为p = 0.03，p = 0.04）。MMC注射与海绵应用一样安全有效，估计完全治疗成功率相当，3个月内就诊的需要较少，并且需要5-FU干预。外科医生可以考虑在适当的患者队列中术中注射MMC，因为其安全性和有效性与传统海绵应用相比具有几个优势。有必要以前瞻性、更大规模、长期的方式进行进一步研究，以评估这种方式。如何引用这篇文章：Khouri AS，Huang G，Huang LY.小梁切除术中术中注射与海绵应用丝裂霉素C：一年研究。J Curr Glaucoma Pract 2017;11（3）：101-106。
To determine the safety and efficacy of intraoperative injection of mitomycin C (MMC) against conventional sponge-applied MMC during trabeculectomy. This study was a retrospective, comparative case series. Thirty eyes with primary open-angle glaucoma underwent consecutive trabeculectomies with MMC injection (injection group), and thirty eyes with sponge-applied MMC were as controls (sponge group). Data were collected preoperatively and postoperatively at 1 day, 1 week, 1 month, 3 months, 6 months, and 1 year after surgery. Demographic data, applanation intraocular pressure (IOP), best-corrected visual acuity (VA), number of glaucoma medications, postoperative interventions, postoperative complications, and number of visits within 3 months were recorded. In order to stratify data, proportion of eyes achieving >30% IOP reduction from baseline with or without glaucoma medications was calculated and defined as surgical success. Mean IOP reduction at 1 year was significant in both the injection and sponge groups from baseline (46.8 and 37.8% respectively). The injection group had overall lower postoperative IOP and comparable complete treatment success, defined as achieving >30% IOP reduction without glaucoma medications (p = 0.941). The number of postoperative visits within 3 months and the proportion of eyes needing 5-fluorouracil (5-FU) intervention were significantly lower in the injection group (p = 0.03, p = 0.04 respectively). Injection of MMC was as safe and effective as sponge application with comparable estimated complete treatment success, less need for visits within 3 months, and 5-FU intervention. Surgeons may consider intraopera-tive injection of MMC in appropriate patient cohorts given comparable safety and efficacy and several advantages over traditional sponge application. Further study in a prospective, larger, long-term manner is necessary to assess this modality. How to cite this article: Khouri AS, Huang G, Huang LY. Intraoperative Injection vs Sponge-applied Mitomycin C during Trabeculectomy: One-year Study. J Curr Glaucoma Pract 2017;11(3):101-106.