Effects of intraoperative 5-fluorouracil or mitomycin C on glaucoma filtration surgery in the rabbit.
Effects of intraoperative 5-fluorouracil or mitomycin C on glaucoma filtration surgery in the rabbit.
复制标题
术中5-氟尿嘧啶或丝裂霉素C对家兔青光眼滤过手术的影响。
DOI：
10.1016/s0161-6420(93)31640-4
复制
发表时间：
1993
期刊：
影响因子：
13.7
通讯作者：
McGorray,S
中科院分区：
文献类型：
--
作者：
Khaw,PT;Doyle,JW;Sherwood,MB;Smith,MF;McGorray,S
目的：确定术中暴露于5-氟尿嘧啶（5-FU）或两种不同浓度的丝裂霉素C（MMC）对兔滤过手术的影响。方法：进行了一项前瞻性、随机、掩蔽观察者、安慰剂对照研究，比较术中暴露于5-FU（50 mg/ml）、MMC（0.2 mg/ml）或MMC（0.4 mg/ml）5分钟对兔滤过手术的影响，对照眼用蒸馏水处理。结果：与对照眼相比，所有三种处理的眼内压（IOPs）保持较长时间较低，滤过泡存活率增加（P × 0.05）。5-FU的作用较MMC短暂。术后滤过泡存活时间依次为MMC0.4> MMC0.2> 5-FU 50 mg/ml。30天时，MMC 0.4 mg/ml组100%的眼睛出现滤过泡，MMC 0.2 mg/ml组60%的眼睛出现滤过泡，5-FU 50 mg/ml或蒸馏水组0%的眼睛出现滤过泡。用MMC治疗的眼睛中的滤过泡较薄，并且仅在用MMC 0.4 mg/ml治疗的眼睛中发生显著的并发症（眼内炎，短暂的角膜混浊和新生血管形成，以及假定的滤过泡渗漏）。结论：作者的结果表明，在这些浓度下，作为单一术中剂量递送的5-FU和MMC，延长了兔中滤过手术的存活时间不同长度，这是一种通常表现出积极愈合和滤过手术快速失败的模型。这些潜在的可滴定的影响，在不同类别的患者滤过手术的影响进行了讨论。
Purpose:To establish the effects of single intraoperative exposures to either 5fluorouracil (5-FU) or two different concentrations of mitomycin C (MMC) on filtration surgery in the rabbit.Methods:A prospective, randomized, masked-observer, placebo-controlled study was performed to compare the effects on filtration surgery in rabbits of a single 5minute intraoperative exposure to 5-FU (50 mg/ml), MMC (0.2 mg/ml), or MMC (0.4 mg/ml) with control eyes treated with distilled water.Results:Intraocular pressures (IOPs) remained lower for longer and bleb survival was increased (PÃ 0.05) with all three treatments compared with control eyes. The effect of 5-FU was more transient than MMC. Bleb survival was prolonged in the following order: MMC 0.4 > MMC 0.2 > 5-FU 50 mg/ml. At 30 days, blebs were present in 100% of eyes treated with MMC 0.4 mg/ml, 60% of eyes treated with MMC 0.2 mg/ml, and 0% of eyes treated with 5-FU 50 mg/ml or distilled water. The blebs in the eyes treated with MMC were thinner, and significant complications (endophthalmitis, transient corneal opacification and neovascularization, and a presumed bleb leak) only occurred in the eyes treated with MMC 0.4 mg/ml.Conclusions:The authors' results suggest that 5-FU and MMC at these concentrations, delivered as a single intraoperative dose, prolong the survival of filtration surgery for different lengths of time in the rabbit, which is a model that normally exhibits aggressive healing and rapid failure of filtration surgery. The implications of these potentially titratable effects for filtration surgery in different categories of patients are discussed.