小樑網切除術不使用mitomycin-C於年輕型青光眼病人的降壓效果

IOP Control of Primary Trabeculectomy without Mitomycin-C in Young Patient

孫銘輝(Ming-Huei Sung) ； 吳秀琛(Hsiu-Chung Wu)

《中華民國眼科醫學會雜誌》 40卷1期 (2001/03) Pp. 25-30

https://doi.org/10.30048/ACTASOS.200103.0004

摘要

目的：評估年輕型無併發性青光眼病人以小樑網切除術不使用Mitomycin-C治療的手術結果。
方法：蒐集1993年7月至1998年12月間26位45歲以下之年輕型無併發性青光眼患者，共35隻患眼其接受小樑網切除術而沒有使用抗代謝藥物(Mitomycin-C)的手術結果。手術的完全成功(complete success)定義為術後眼壓小於或等於21mmHg而不使用任何降眼壓藥物，合格成功(qualified success)定義為術後使用少於或等於一種降眼壓藥物其眼壓小於或等於21mmHg。
結果：病人術前眼壓平均22.2±7.9mmHg，平均使用2.8±0.8種降眼壓藥物，術後在第6，第12，第24及第36個月的平均眼壓分別為12.8±3.1mmHg，14.9±3.3mmHg，15.6±3.4mmHg，15.7±2.7mmHg。Kaplan-Meier存活分析曲線(Kaplan-Meier survival analysis)顯示第6，第12，第24及第36個月其手術完全成功率分別為91.3%，78.0%，62.4%及53.5%，手術合格成功率分別為97.1%，90.8%，90.8%，85.8%。而那些不符合成功標準的病人術後也只需要平均1.1±0.3種降壓藥物來控制眼壓，而且沒有病人需要再次接受手衍治療。
結論：年輕型青光眼患者接受小樑網切除術而沒有使用抗代謝藥物(Mitomycin-C)可獲至有效的降壓效果。

並列摘要

Purpose: To evaluate the outcome of initial trabeculectomy without mitomycin-C in young patients.
Materials and Methods: A retrospective review of patients under the age of 45 years old who had undergone primary trabeculectomy without the use of antimetabolite between July1993 and December 1998, with a minimum follow-up of 7 months, was performed. 35 eyes of 26 patients (33 POAG, 1 Pigmentary glaucoma, 1 Sturge-Weber syndrome) were included in this study. Age ranged from 7 to 45 years old (27.1±10.2). The follow-up period ranged from 7 to 72 months (32.1±18.5) Complete successful control of IOP was defined as IOP≤21mmHg without antiglaucoma medication, and qualified success was defined as IOP≤21mmHg with only one medication.
Result: Preoperative mean IOP was 22.2±7.9mmHg with a mean number of 2.8±0.8 antiglaucoma medications. Postoperative mean IOP at 6, 12, 24, and 36 months was 12.8±3.1mmHg, 14.9±3.3mmHg, 15.6±3.4mmHg, and 15.7±2.7mmHg. Kaplan-Meier survival analysis showed that the complete success probability at 6, 12, 24, and 36 months was 91.3%, 78.0%, 62.4%, 53.5%, and the qualified success probability was 97.1%, 90.8%, 90.8%, 85.8%. In those who not reaching the success criteria, all their IOP can be controlled by additional antiglaucoma medication (mean no.: 1.1±0.3 at the end of 36 months follow-up). No patient required further surgical intervention to lower IOP in this series.
Conclusion: Primary trabeculectomy with no use of antimetabolite may have sufficiently favorable IOP lowering effect in young patients.

並列關鍵字

Trabeculectomy ； Young Patient ； Mitomycin-C