抗癌劑mitomycin-C輔助小樑切除術對青光眼眼壓控制效果一年以上之追踪成績

Enhancement of IOP Control Effect of Trabeculectomy by Local Application of Anticancer Drug

陳振武(Chen-Wu Chen) ； 黃河東(Ho-Tung Huang) ； 李秋忠(Chiou-Chorn Lee)

《中華民國眼科醫學會會刊》 25卷2期 (1986/05) Pp. 498-502

https://doi.org/10.30048/ACTASOS.198605.0090

摘要

為抑制青光眼手術後手術創周圍纖維組織之增殖，保持其過濾作用而提高青光眼手術之長期性眼壓控制效果，自民國七十年五月起我們導入小樑切除手術輔以mitomycin-C之局部數用之新手術處置方法。則做小樑切除手術時，結膜瓣、鞏膜瓣剝離後以0.1，0.2，或0.4mg/ml三種不同濃度mitomycin-C溶液敷於手術創周圍之剝離暴露之結膜下，Tenon膜，上鞏膜組織，五分鐘之後冲洗藥物，進行完成手術。至民國七十五年四月止共44人，52眼，其年齡6個月至88歲接受本手術，這些病例曾接受過其他方法青光眼手術而無法控制眼壓上昇，或具有預期成績不佳條件之病型或病人條件譬如幼年等。52眼中5眼失去追踪。47眼追踪1~4年，結果有43眼(91.5%)眼壓控制在20mmHg以下。眼壓控制良好在20mmHg以下者，43眼中20眼視力改善，23眼不變，另一眼眼壓在22mmHg雖然歸類為眼壓控制失敗，但其視力有改善。使用0.2或0.4mg/ml者效果比0.1mg/ml好，但0.4mg/ml者比0.2mg/ml的低眼壓症之發生較多。

並列摘要

To inhibit the ensuing proliferative tissue formation after glaucoma surgery, mitomycin-C, an anticancer drug was applied locally to the exposed Tenon's and scleral tissues during a trabeculectomy. The drug was in concentrations of 0.1, 0.2, or. 0.4 mg/ml and was applied for 5 minutes.
Fifty-two eyes in 44 patients with glaucoma, ages from 6 months to 88 years, that either had failed previous operation or had other difficulties, received the present procedures. 47 eyes were followed for more than 1 year and up to 4 years.
The over-all success rate in IOP control that was under 20 mmHg was 91.5%. The conjunctival bleb formation had a higher occurrence and was prominent after 1 year postoperatively. The relations among the success rate, ages, concentration of the drug used and glaucoma types are discussed.

並列關鍵字

anticancer drug ； glaucoma ； fibrous tissue ； trabeculectomy