ABSTRACT

Purpose

: To evaluate the outcomes of primary trabeculectomy with mitomycin-C (trab MMC) in phakic eyes with post-traumatic angle recession glaucoma with no prior intraocular surgeries.

Methods

: We included 32 phakic eyes of 32 patients who underwent trab MMC between January-2002 and December-2017. Complete success was IOP between 6 and 21 mm Hg without anti-glaucoma medications (AGM) and failure was when IOP >21 mm Hg with AGM or need for additional intervention for IOP control or loss of light perception.

Results

: Thirty-two eyes of 32 subjects with a mean age (± standard deviation) of 30.6 ± 12.6 years were included. The majority were male (97.6%) and the major cause of blunt trauma were sports injury in 28/32 eyes (88%) and 24/32 eyes (75%) had >180-degree angle recession. The Median (interquartile range) follow-up duration was 1.3 years (0.3,3.5). There was significant IOP reduction at 1-year postoperatively (34 (28,40) to 13 (12,16) mm Hg; p < .001). The median postoperative AGM at 1-year was significantly less (4 (3,4) to 0; p < .001) with stable Log MAR visual acuity (p = .24). The complete survival of trab MMC was 88% at 1 year and was 77% from 2 to 5 years. Complications were intraoperative vitreous prolapse needing limited vitrectomy in two eyes and postoperative choroidal detachment in two eyes that resolved with conservative management. The contralateral eyes of three patients (9.7%) developed elevated IOP during the follow-up period.

Conclusion

: Trabeculectomy with mitomycin-C in phakic eyes with traumatic angle recession glaucoma showed good safety and efficacy in the medium-term follow-up. The contralateral fellow eye needs monitoring for glaucoma in these patients.

中文翻译：

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丝裂霉素-C 小梁切除术治疗有晶状体眼的创伤后角衰退性青光眼，无需事先进行眼内干预

摘要

目的

: 评估原发性小梁切除术与丝裂霉素-C (trab MMC) 在有晶状体眼的创伤后角衰退性青光眼患者中的结果，且之前未进行过眼内手术。

方法

：我们纳入了 2002 年 1 月至 2017 年 12 月期间接受 trab MMC 的 32 名患者的 32 只有晶状体眼。完全成功是在没有抗青光眼药物 (AGM) 的情况下眼压在 6 至 21 毫米汞柱之间，而当眼压 > 21 毫米汞柱并使用 AGM 或需要额外干预以控制眼压或失去光感时，则完全成功。

结果

：包括 32 名受试者的 32 只眼，平均年龄（± 标准差）为 30.6 ± 12.6 岁。大多数是男性（97.6%），钝性外伤的主要原因是 28/32 眼（88%）的运动损伤和 24/32 眼（75%）有 >180 度角后退。中位（四分位距）随访时间为 1.3 年（0.3,3.5）。术后 1 年眼压显着降低（34 (28,40) 至 13 (12,16) mm Hg；p < .001）。术后 1 年的中位 AGM 显着降低（4 (3,4) 至 0；p < .001），Log MAR 视力稳定（p= .24)。trab MMC 的完全存活率在 1 年时为 88%，在 2 至 5 年时为 77%。并发症是术中玻璃体脱垂，两只眼睛需要有限的玻璃体切除术，两只眼睛术后脉络膜脱离，保守治疗解决。三名患者（9.7%）的对侧眼在随访期间出现眼压升高。

结论

: 丝裂霉素-C 小梁切除术对有晶状体眼外伤性角衰退青光眼的中期随访显示出良好的安全性和有效性。这些患者的对侧对侧眼需要监测青光眼。