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目的探讨在先天性青光眼小梁切开联合小梁切除术中应用不同浓度丝裂霉素C的临床疗效。方法将96例(124眼)先天性青光眼患者随机分为三组,所有患者行小梁切开联合小梁切除术,第一组32例(41眼)给予0.01%丝裂霉素C,第二组31例(40眼)给予0.02%丝裂霉素C,第三组33例(43眼)给予0.04%丝裂霉素C,比较观察三组患者的临床疗效及并发症。结果三组患者总有效率分别为87.80%、90.00%、88.37%,三组间无统计学差异(P>0.05)。三组患者术后1周眼压较术前均有显著降低,差异有统计学意义(P<0.05)。三组患者术后1周眼压降低幅度随浓度升高而增大,差异有统计学意义(P<0.05)。三组患者术后1个月、术后3个月、术后6个月眼压较术后1周变化不大,差异无统计学意义(P>0.05)。三组术后出现并发症百分比分别为31.71%、22.50%、32.56%,0.02%丝裂霉素C组比0.01%、0.04%丝裂霉素C组并发症更少,差异有统计学意义(P<0.05)。结论小梁切开联合小梁切除术联合丝裂霉素C治疗先天性青光眼临床疗效较好,推荐临床给予0.02%丝裂霉素C以期获得更好疗效和更少并发症。
Objective To investigate the clinical effects of mitomycin C at different concentrations in trabeculectomy combined with trabeculectomy for congenital glaucoma. Methods 96 patients (124 eyes) with congenital glaucoma were randomly divided into three groups, all patients underwent trabeculectomy combined with trabeculectomy, the first group of 32 patients (41 eyes) given 0.01% mitomycin C, the first Twenty-one patients (40 eyes) in the second group received 0.02% mitomycin C and the third group (43 eyes) received 0.04% mitomycin C. The clinical efficacy and complications of the three groups were compared. Results The total effective rates of the three groups were 87.80%, 90.00% and 88.37% respectively. There was no significant difference among the three groups (P> 0.05). The intraocular pressure of the three groups of patients was significantly lower than that before the operation, the difference was statistically significant (P <0.05). One week after operation, the IOP decreased with the increase of concentration in three groups, the difference was statistically significant (P <0.05). The three groups of patients after 1 month, 3 months after surgery, 6 months after IOP compared with 1 week after operation, the difference was not statistically significant (P> 0.05). The complication rates of three groups were 31.71%, 22.50%, 32.56%, 0.02% mitomycin C group were less than 0.01%, 0.04% mitomycin C group were less complications, the difference was statistically significant ( P <0.05). Conclusion Trabeculectomy combined with trabeculectomy combined with mitomycin C in the treatment of congenital glaucoma clinical efficacy is better, recommended 0.02% mitomycin C clinical in order to obtain better efficacy and fewer complications.