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首页> 外文期刊>Journal of glaucoma >Surgical revision of failed filtration surgery with mitomycin C augmentation.
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Surgical revision of failed filtration surgery with mitomycin C augmentation.

机译：丝裂霉素C增强术失败的滤过手术的手术修订。

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AIM: The aim of the study was to assess the outcomes of surgical revision with reopening of the scleral flap in eyes with failed glaucoma surgery and adjunctive mitomycin C (MMC). METHODS: Retrospective, noncomparative, interventional case series. Fifty-four eyes of 54 consecutive patients with previously failed trabeculectomy or deep sclerectomy who underwent formal surgical revision (23 with concurrent phacoemulsification) were included. MMC, 0.2 mg/mL for 2 to 3 minutes, was applied under a fornix-based conjunctival flap. The preexisting scleral flap was dissected open to reestablish filtration. RESULTS: Mean follow-up was 39.5+/-10 months. Kaplan-Meier survival analysis showed that the probability (with 95% confidence intervals) of maintaining an intraocular pressure (IOP) between 5 and 18 mm Hg and 20% decrease from preoperative IOP was 64% (47% to 76%) with medications and/or needle revision and 38% (26% to 53%) without, 3 years after surgery. Mean IOP before surgery was 23.6+/-7.2 mm Hg and 14.4+/-6.0 three years after surgery (last IOP before further glaucoma procedure carried forward). Needle revision for bleb failure or high IOP was carried out in 23 eyes (42.5%) and further glaucoma surgery in 5 eyes (9.3%). Patients were on an average of 2+/-1.1 glaucoma medications before surgery. At last follow-up, the number of medications had decreased to 0.8+/-1.2 (P<0.000), with 23 eyes (42.5%) requiring medications to control IOP. Significant complications included delayed suprachoroidal hemorrhage (3 eyes, 5.6%), delayed bleb leaks (5 eyes, 9.3%), hypotony (2 eyes, 3.7%), and blebitis (2 eyes, 3.7%). CONCLUSIONS: There is a progressive increase in IOP with time after surgical revision of failed glaucoma surgery with adjunctive MMC. A significant proportion of eyes will eventually require a needle revision procedure and/or glaucoma medications to further lower IOP. Also, there is a significant incidence of complications associated with this procedure.
机译：目的：该研究的目的是评估青光眼手术失败并伴有丝裂霉素C（MMC）的眼睛中巩膜瓣重新张开的手术翻修结果。方法：回顾性，非比较性，介入性病例系列。纳入54例连续小梁切除术或深层巩膜切除术失败的连续患者的54只眼睛，这些患者接受了正式的外科手术修订（23例同时进行超声乳化术）。在基于穹ni的结膜瓣下应用0.2 mg / mL的MMC 2至3分钟。将先前存在的巩膜瓣切开以重新建立过滤。结果：平均随访时间为39.5 +/- 10个月。 Kaplan-Meier生存分析表明，用药物和药物治疗将眼内压（IOP）维持在5至18 mm Hg之间且术前IOP降低20％的可能性为64％（47％至76％）。 /或术后3年不进行针头翻修和不进行针头翻修的占38％（26％至53％）。术后三年平均眼压为23.6 +/- 7.2 mm Hg，术后三年平均眼压为14.4 +/- 6.0（在进一步进行青光眼手术之前的最后一次眼压）。对23眼（42.5％）进行了眼球翻修或高眼压的针修复，5眼（9.3％）进行了青光眼手术。术前患者平均接受2 +/- 1.1次青光眼用药。在最后一次随访中，药物数量已降至0.8 +/- 1.2（P <0.000），其中有23只眼（42.5％）需要药物来控制IOP。重大并发症包括：脉络膜上膜出血延迟（3眼，5.6％），延迟性小渗漏（5眼，9.3％），肌张力低下（2眼，3.7％）和睑缘炎（2眼，3.7％）。结论：伴有MMC的青光眼手术失败的手术改版后，眼压随时间的增加而逐渐增加。很大一部分眼睛最终将需要进行针头翻修手术和/或青光眼药物以进一步降低IOP。而且，与此手术相关的并发症的发生率也很高。

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