Clinical and Experimental Studies on Modification of Glaucoma Surgery

点击翻译按钮获取中文摘要

Clinical data analysis : The surgical outcome of trabeculectomy with mitomycin C in glaucoma patients was critically reviewed. We have shown that the filtering bleb was categorized into four typical ones based on ultrasound biomicroscopic findings. In normal-tension glaucoma, trabeculectomy alone brought sufficient reduction of the intraocular pressure (IOP) to 90% of the cases and exerted a favorable effect on the visual field. The favorable effect of the surgery was more prominent in cases with the preoperative IOP of 15 mmHg or higher. Postoperative cataract development was found to occur much earlier than it was thought before. Postoperative infection has not increased in our cases trabeculectomized with mitomycin C.Postoperative corneal astigmatism : Development of corneal astigmatism following glaucoma filtering surgery was prospectively investigated using a computerized corneal topographic measurement system. We found that the steepest meridian corresponded to the direction of the scleral flap and that the astigmatism remained unchanged during the 12-month follow-up period. There seems to be no relationship between the magnitude of astigmatism and the number of stitches, IOP or performing laser suture lysis.New administration method of mitomycin C : A new administration method of mitomycin C using a thermosetting gel was found to reduce the dosage of the antiproliferative agent up to one-seventieth as compared to the conventional one. Ocular hypotensive effect of trabeculectomy adjunctive to the new administration method is almost similar to the conventional method in a glaaucoma surgery model in the rabbit.