[5-氟尿嘧啶在小梁切除术中的初步报道]。

S Jeng, W C Ku, D Fan
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摘要

结膜下5-FU注射是青光眼高危患者小梁切除术的辅助治疗方法。作为常规治疗,我们每天注射一次5毫克,持续5到7天。对于前10只眼睛,手术后立即开始注射。然而,对于其余的9只眼睛,在术后24至48小时开始注射。如果水泡的外观不突出或血管丰富,注射的持续时间应延长至10至14天。19只眼至少随访8个月,其中无晶状体青光眼8只眼;新生血管性青光眼2眼;之前失败的滤镜,6只眼睛;前房完全塌陷伴白斑粘附,1眼;中胚层发育不良所致青光眼1眼;青少年青光眼,1只眼睛(另一只眼睛接受了两次失败的过滤手术)。结果显示,成功率为79%(眼压低于22mmHg,有或没有外用药物)。无晶状体青光眼的成功率为63%(5/8),新生血管性青光眼的成功率为100%(2/2),滤光片失败的成功率为83%(5/6)。我们也认为5-FU注射对于治疗由年龄因素引起的异常明显的纤维增生是有效的。与使用5-FU相关的并发症包括角膜上皮缺损4/9(21%)、结膜渗漏3/9(16%)、结膜下血肿1/19(5%)、结膜无菌性溃疡1/19(5%)。
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[5-Fluorouracil in trabeculectomy: preliminary report].

Subconjunctival 5-FU injections were used as an adjunctive therapy in trabeculectomy for high risk glaucoma patients. We injected 5 mg once a day for five to seven days as a routine treatment. For the first 10 eyes, the injections were started immediately after the operation. However, for the remaining 9 eyes, the injections began 24 to 48 hours postoperative. If the appearance of the bleb was not prominent or enriched in vascularity, the duration of the injections should be extended to 10 to 14 days. At least 8 months of follow-up were available for 19 eyes, including aphakic glaucoma, 8 eyes; neovascular glaucoma, 2 eyes; previous failed filter, 6 eyes; total collapse of the anterior chamber with leucoma adherence, 1 eye; glaucoma due to mesodermal dysgenesis, 1 eye; and juvenile glaucoma, 1 eye (whose fellow eye had received twice failed filtering procedures). The results revealed a success rate of 79% (intraocular pressure below 22mmHg with or without topical medication). The success rate for aphakic glaucoma was 63% (5/8), for neovascular glaucoma 100% (2/2) and for the failed filters 83% (5/6). We also presume that 5-FU injections would be effective in the treatment of to abnormally marked fibrous proliferations caused by age factors. The complications related to the use of 5-FU include corneal epithelial defect 4/9 (21%), conjunctival leak 3/9 (16%), subconjunctival hematoma 1/19 (5%), and conjunctival sterile ulcer 1/19 (5%).

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