儿童青光眼的强化小梁切除术

来源 :世界核心医学期刊文摘.眼科学分册 | 被引量 : 0次 | 上传用户:qq184343882
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Aims: To report the experience with trabeculectomy augmented with mitomycin C and 5- fluorouracil for the treatment of paediatric glaucoma. Methods: Retrospective, interventional case series design was used. The sample included 17 children (29 eyes) with primary (19 eyes) or secondary (10 eyes) glaucoma who were treated with augmented trabeculectomy as the primary procedure between 1990 and 2002. Data were collected on age and family history, preoperative and end of follow up intraocular pressure, cup/disc ratio (evaluated by drawing), visual acuity, complications, and post-surgery treatment. Results: Patient age at surgery ranged from 1 month to 8 years; most patients (n=14, 82.3% ) were aged less than 1 year (range 1 month-8 months, mean 3.95 (SD 2.56) months); three patients (17.7% ) were aged3, 5, and 8 years. The duration of follow up was 3- 120 months (mean 46 months). Intraocular pressure significantly improved from 21 mm Hg to 60 mm Hg (mean33.1 (10) mm Hg) before surgery to 6- 26 mm Hg (mean 17.1 (6) mm Hg) after, (P < 0.0001). There was no significant change in cup/disc ratio: 0.1- 0.8 (mean 0.42 (0.26)) before and 0.1- 1.0 (mean 0.511 (0.27)) after (P=0.45). In 22 eyes (75.8% ), intraocular pressure was controlled at less than 20 mm Hg and the cup/disc ratio remained stable or improved. The life table success rate for intraocular pressure control remained stable at 86% at the 12, 24, and 36 months and after 48 months decreased to 53% . There was no significant difference in the life table results between primary and secondary glau coma. 14 eyes (48.2% ) had a visual acuity better than 20/120 by the end of follow up. Repeated surgery was necessary in eight eyes (27.5% ), and additional antiglaucoma treatment in 13 (44.8% ). Complications included retinal detachment 1 year after surgery, choroidal detachment, and blebitis (one eye each). Conclusions: Augmented trabeculectomy with mitomycin C and 5- fluorouracil may serve as the primary procedure in a selected group of paediatric patients with glaucoma. Aims: To report the experience with trabeculectomy augmented with mitomycin C and 5-fluorouracil for the treatment of pediatric glaucoma. Methods: Retrospective, interventional case series design was used. The sample included 17 children (29 eyes) with primary (19 eyes) or secondary (10 eyes) glaucoma who were treated with augmented trabeculectomy as the primary procedure between 1990 and 2002. Data were collected on age and family history, preoperative and end of follow up intraocular pressure, cup / disc ratio (evaluated by drawing), visual Results: Patient age at surgery ranged from 1 month to 8 years; most patients (n = 14, 82.3%) were aged less than 1 year (range 1 month-8 months, mean 3.95 (SD 2.56) months); three patients (17.7%) were aged 3, 5, and 8 years. The duration of follow up was 3- 120 months (mean 46 months). Intraocular pressure significantly improved from 21 mm Hg to 60 mm Hg (mean33.1 (10) mm Hg) before surgery to 6- There was no significant change in cup / disc ratio: 0.1-0.8 (mean 0.42 (0.26)) before and 0.1-1.0 (mean 0.511 (mean 17.1 (6) mm Hg) after 0.27)) after (P = 0.45). In 22 eyes (75.8%), intraocular pressure was controlled at less than 20 mm Hg and the cup / disc ratio remained stable or improved. The life table success rate for intraocular pressure control remained stable at was 86% at the 12, 24, and 36 months and after 48 months decreased to 53%. There was no significant difference in the life table results between primary and secondary glau coma. 14 eyes (48.2%) had a visual acuity better than 20/120 by the end of follow up. Repeated surgery was necessary in eight eyes (27.5%), and additional antiglaucoma treatment in 13 (44.8%). Complications included retinal detachment 1 year after surgery, choroidal detachment, and blebitis each). Conclusions: Augmented trabeculectomy with mitomycin C and 5-fluorouracil may serve as the primary procedure in a selected group of pediatric patients with glaucoma.
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