丝裂霉素C对白内障合并青光眼患者角膜内皮细胞的影响
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Influence of mitomycin C on corneal endothelial cell in phacoemulsification combined trabeculectomy
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    摘要:

    目的:观察丝裂霉素C在超声乳化联合小梁切除术中对角膜内皮细胞的影响。

    方法:选取本院收治的58例58眼青光眼合并白内障患者,随机分为两组,每组各29例29眼。两组患者均予以超声乳化联合小梁切除术,对照组术中不使用抗代谢药物,观察组以0.2g/L丝裂霉素浸润2min。比较两组患者手术前后视力与眼压、滤过泡形态与并发症,并采用角膜地形图测量平均中央角膜厚度,采用非接触型角膜内皮镜测定角膜内皮细胞密度、六角形细胞比率和变异系数。

    结果:术前,两组患者视力差异无统计学意义(P>0.05); 术后,两组患者视力较术前有所提高,但组间差异无统计学意义(P>0.05)。术前,两组患者眼压差异无统计学意义(P>0.05); 术后,两组患者眼压均有所降低,且观察组低于对照组,组间和组内差异均有统计学意义(P<0.05)。术后,两组患者间功能型滤过泡形成率差异无统计学意义(P>0.05); 观察组并发症发生率低于对照组,组间差异有统计学意义(P<0.05)。术后,两组患者的平均中央角膜厚度、内皮细胞密度、六角形细胞比率及变异系数均无明显变化,且手术前后的组间差异也无统计学意义(P>0.05)。

    结论:超声乳化联合小梁切除术中应用丝裂霉素C利于稳定眼压,减少术后并发症,且并不增加角膜内皮细胞损伤风险。

    Abstract:

    AIM: To observe the influence of mitomycin C on corneal endothelial cell in phacoemulsification combined trabeculectomy.

    METHODS: Totally 58 patients with cataracts and glaucoma were selected and divided into 2 groups randomly, with 29 cases in each. All patients were treated with phacoemulsification combined trabeculectomy, and those of the control group used no anti-metabolism drugs in the surgery, while those of the observation group given 0.2mg/mL mitomycin C in the surgery. The visual acuity and intraocular pressure, filtering bleb form and complications were compared before and after treatment. Further more, central corneal thickness of patients was detected by corneal topography, and corneal endothelial cell density, hexagonal cell percentage, and variable coefficient of patients were detected with non-contact corneal endothelium.

    RESULTS: Before surgery, there was no significant difference in visual acuity between groups(P>0.05); after surgery, the visual acuity of both groups increased, and there was no significant difference between groups either(P>0.05). Before surgery, there was no significant difference on intraocular pressure between groups(P>0.05); after surgery, the intraocular pressure of both groups decreased, and that of the observation group was lower than the controls, the difference between groups and in-groups were both had statistical significance(P<0.05). After surgery, there was no significant difference in functional filter follicle formation rate between groups(P>0.05), but the complication rate of observation group was lower than the controls(P<0.05). After operation, the central corneal thickness, corneal endothelial cell density, hexagonal cell ratio and variation coefficient of the two groups showed no significant change, and there was no statistically significant difference between groups either(P>0.05).

    CONCLUSION: Using mitomycin C in the surgery of phacoemulsification combined trabeculectomy is benefit to stabilize intraocular pressure and reduce postoperative complication rate, without the risk of injuring corneal endothelial cells.

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郑鑫,麻伟南,叶春华.丝裂霉素C对白内障合并青光眼患者角膜内皮细胞的影响.国际眼科杂志, 2018,18(1):96-99.

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  • 收稿日期:2017-09-01
  • 最后修改日期:2017-11-29
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  • 在线发布日期: 2017-12-18
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