マイトマイシンCを用いた線維柱帯切除術0.02％と0.04％の効果の比較

Trabeculectomy using topical mitomycin C. Comparison of 0.02% and 0.04% solution

　線維柱帯切除術におけるマイトマイシンC （MMC）の術中投与量と術後成績について検討した。初回手術，または過去1回の線維柱帯切除術の既往のあるlow risk群（n＝81）と同手術の予後不良因子をもつhigh risk群（n＝45）についてMMC 0.02％と0.04％使用例の術後成績を比較した。両群ともMMC 0.04％使用例で眼圧コントロールはMMC 0.02％使用例より良好であり，平均眼圧も低く，MMC濃度と臨床効果間には0.02％と0.04％間で差がみられた。術直後2週間の平均眼圧がlow risk群MMC0.02％使用例で平均6mmHg以下，0.04％使用例で平均11mmHg以下の症例は有意に眼圧コントロール良好であった。

We reviewed the surgical outcome following trabeculectomy in 126 eyes with various types of glaucoma. Mitomycin C was applied to the bared sclera either as 0.02% or 0.04% solution. The series was divided into two groups. Low risk group comprised 81 eyes of primary glaucoma which underwent trabeculectomy as first or second surgery. High risk group comprised 55 eyes with complications as uveitis or aphakia. Postoperative intraocular pressure (IOP) was significantly lower in both groups when treated with 0.04% than 0.02% solution. Hypotony maculopathy developed in 3 eyes treated with 0.04% solution. There was a significant correlation between longterm IOP control and IOP level two weeks after surgery in low risk group, the criteria being 6mmHg for 0.02% and 11mmHg for 0.04% solution.