青光眼手術中使用Mitomycin-C後發生低眼壓性黃斑部病變之探討

Hypotony Maculopathy Following the Use of Topical Mitomycin-C in Glaucoma Filtration Surgery

黃照文(Chao-Wen Huang) ； 白佳欣

《中華民國眼科醫學會雜誌》 35卷4期 (1996/12) Pp. 412-418

https://doi.org/10.30048/ACTASOS.199612.0005

摘要

手術中使用Mitomycin-C已被證實能有效地提高青光眼手術的成功率。本篇報告收集了自1990年6月到1994年2月，112位131隻曾接受青光眼手術，術中合併使用Mitomycin-C的眼睛。術後發現11隻眼睛有低眼壓性黃斑部病變。其中4隻眼睛（佔3.0%）有明顯嚴重的變化，包括：脈絡膜視網膜皺褶、血管扭曲、視神經盤水腫和局部的脈絡膜剝離。其餘7隻眼睛（佔5.3%）只是有輕微的黃斑部紋痕(macular striae)。在平均追蹤治療13.1個月後，4隻嚴重變化的病眼無法回復術前視力，而7隻輕微變化的眼睛均能回復術前視力。所以，如年輕、近視等容易造成低眼壓性黃斑部病變的高危險群患者在施用Mitomycin-C時應該仔細評估，並儘量避免此併發症的發生。

並列摘要

Topical intraoperative mitomycin C has been demonstrated to be highly effective in increasing the success of glaucoma filtration surgery. We collected 131 eyes of 112 patients who underwent filtration procedures with intraoperative mitomycin C between June 1990 and Feb. 1994. Of the 112 patients. 19 patients underwent the procedure in both eyes. In addition, 3 eyes received twice surgery and I eyes received three times. In the post operative period, 11 eyes developed hypotony maculopathy. And 4 eyes (3.0%) out of 11 were severe form, characterized by chorioretinal fold, vascular tortuosity, disc edema, and localized choroidal detachmemt. The rest of 7 eyes (5.3%) were mild form that characterized by macular striae. After a mean follow up of 13.1 months, the visual acuity of the 4 eyes with severe form didn't return to the pre-operative levels. However, we found that 7 eyes mild form had recovered.

並列關鍵字

Hypotony maculopathy ； Mitomycin-C ； Glaucoma filtration surgery