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題 名 | Effect of Mitomycin C for Combined Trabeculectomy and Phacoemulsification=Mitomycin C 運用在小樑切除術合併超音波晶體乳化術之有效性及安全性 |
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作 者 | 劉瑞玲; 蘇惠珍; 周清光; 許紋銘; 劉榮宏; | 書刊名 | 中華醫學雜誌 |
卷 期 | 63:1 2000.01[民89.01] |
頁 次 | 頁28-36 |
分類號 | 416.748 |
關鍵詞 | 青光眼白內障聯合手術; 青光眼; 眼壓; 超音波晶體乳化術; 小樑切除術; Combined surgery; Glaucoma; Intraocular pressure; Mitomycin C; Phacoemulsification; Trabeculectomy; |
語 文 | 英文(English) |
中文摘要 | 背景:評估在小樑切除術合併超音波晶體乳化術中使用mitomycin C (MMC)的有效性、安全性及長期降眼壓的效果。 方法:我們回顧1996年7月至1998年3月期間所有接受小樑切除術合併超音波晶體乳化術之患者的臨床資料,並比較術中接受MMC的22隻眼(22人)和未接受MMC的18隻眼(18人)之術前基本資料、術後定期追蹤之眼壓、青光眼用藥數目、視力及併發症。 結果:在術後12個月的追蹤中發現,兩組的平均視力皆較術前有顯著進步,而兩組之間並無顯著差異。MMC組平均眼壓自術前16.1 ± 4.0 mm Hg降到11.4 ± 3.3 mm Hg,對照組平均眼壓自術前18.7 ± 6.9 mm Hg降到14.6 ± 1.9 mm Hg。在術後第1、2週、第1、2、9及12個月,MMC組的平均眼壓皆顯著比對照組低。兩符組的術後青光眼用藥平均數目皆有明顯下降,尤以 MMC 組所需藥物的減少更為顯著。此外,MMC組有明顯較高的術後12個月手術成功率。 結論:在小樑切除術合併超音波晶體乳化術中使用MMC能增加降眼壓療效,且能減少對青光眼藥物之依賴。 術後視力的回復情形並未因使用MMC而受影響,也未發現有嚴重的併發症。 |
英文摘要 | Background: To evaluate the efficacy and safety of intraoperative mitomycin C (MMC) for trabeculectomy combined with phacoemulsification (phacotrab) in patients with coexisting glaucoma and cataract. Methods: We retrospectively reviewed the charts of consecutive patients who underwent phacotrab from July, 1996, to March, 1998. The pre- and postoperative intraocular pressure (IOP), number of glaucoma medications, visual acuity (VA), and postoperative complications were compared among 22 patients (22 eyes) who received intraoperative MMC and 18 patients (18 eyes) who did not receive MMC, served as the control group. Data of age, gender, type of glaucoma, number of glaucoma medications, cup-to-disc ratio of the optic nerve and the extent of visual field defects were also evaluated. Kaplan-Meier survival analysis was used to compare the surgical success rates between two groups. Results: The mean IOP decreased from 16.1 ± 4.2 mmHg to 10.94 ± 3.6 mmHg in the MMC group, and from 18.7 ± 6.9 mmHg to 14.6 ± 1.9 mmHg in the control group at one year of follow-up. The mean postoperative IOPs were significantly lower in the MMC group than in the control group at one week, two weeks, and one, two, nine and 12 months. Postoperative mean VA log minimum angle of resolution (MAR) improved significantly in both groups. The mean number of medications decreased from 1.91 ± 0.75 to 0.18 ± 0.50 in the MMC group, and from 1.89 ± 0.47 to 0.72 ± 0.75 in the control group (p<0.001 for both). The one-year complete success rate was significantly higher in the MMC group (p=0.0038) than in the control group. No major complication was found throughout the study. Conclusions: Intraoperative MMC in phacotrab may improve postoperative filtration with less dependence on glaucoma medication. No significant adverse effects were associated with MMC application. |
本系統中英文摘要資訊取自各篇刊載內容。