5-fluorouracil and glaucoma filtering surgery. II. A pilot study.
5-fluorouracil and glaucoma filtering surgery. II. A pilot study.
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DOI：
10.1016/s0161-6420(84)34291-9
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发表时间：
1984-04
期刊：
影响因子：
13.7
通讯作者：
D. Heuer;Richard K. Parrish;M. Gressel;Elizabeth Hodapp;P. Palmberg;Douglas R. Anderson
中科院分区：
文献类型：
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作者：
D. Heuer;Richard K. Parrish;M. Gressel;Elizabeth Hodapp;P. Palmberg;Douglas R. Anderson
在一项针对手术预后不良的眼睛的初步研究中，青光眼滤过手术后，将 5-氟尿嘧啶 (5-FU) 注射到结膜下。 34 只患有青光眼的无晶状体眼中，有 27 只 (79%) 的眼压 (IOP) ≤ 21 mmHg（未再次手术眼的随访范围为 91-468 天）。 13 只患有新生血管性青光眼的眼睛中，有 9 只 (69%) 的 IOP ≤ 21 mmHg（未再次手术的眼睛的随访范围为 120-379 天）。滤过手术失败后患有青光眼的 9 只有晶状体眼中的 8 只 (89%) 的 IOP ≤ 21 mmHg（未再次手术的眼睛的随访范围为 134-394 天）。在 34 只患有青光眼的无晶状体眼中，有 32 只（94%）的视力与术前水平保持在一线以内，在 13 只患有新生血管性青光眼的眼睛中，有 8 只（62%）的视力保持在术前水平的一线以内，在滤过手术失败后，在 9 只患有青光眼的有晶状体眼中，有 6 只（67%）的视力得到改善。 45%的病例发生术后角膜上皮缺损。 41%的病例出现结膜伤口和结膜针道渗漏，但只有一只眼睛需要伤口翻修。没有观察到我们归因于 5-FU 的其他严重副作用。对于手术预后不良的眼睛，术后结膜下 5-FU 似乎可以增加滤过手术后实现 IOP 控制的可能性；然而，需要进行随机临床试验来证实这一点。
5-Fluorouracil (5-FU) was injected subconjunctivally after glaucoma filtering surgery in a pilot study of eyes with poor surgical prognoses. Twenty-seven (79%) of the 34 aphakic eyes with glaucoma achieved an intraocular pressure (IOP) of ≤21 mmHg (range of follow-up on nonreoperated eyes, 91–468 days). Nine (69%) of 13 eyes with neovascular glaucoma achieved an IOP of ≤21 mmHg (range of follow-up on nonreoperated eyes, 120–379 days). Eight (89%) of nine phakic eyes with glaucoma following unsuccessful filtering procedures achieved an IOP of ≤21 mmHg (range of follow-up on nonreoperated eyes, 134–394 days). Visual acuities remained within one line of their preoperative levels or improved in 32 (94%) of the 34 aphakic eyes with glaucoma, eight (62%) of the 13 eyes with neovascular glaucoma, and six (67%) of the nine phakic eyes with glaucoma following unsuccessful filtering procedures. Postoperative corneal epithelial defects occurred in 45% of the cases. Conjunctival wound and conjunctival needle tract leaks were observed in 41% of the cases, but only one eye required wound revision. No other serious side effects that we attributed to 5-FU were observed. It seems that postoperative subconjunctival 5-FU increases the likelihood of achieving IOP control following filtering surgery in eyes with poor surgical prognoses; however, a randomized clinical trial is necessary to confirm this.