異なる濃度のマイトマイシンCを用いた線維柱帯切除術の術後成績—マイトマイシンC濃度0.2mg/mlと0.4mg/mlの術後短期成績の比較検討

Outcome of trabeculectomy using mitomycin C of different concentrations A short-term comparison of 0.2 and 0.4mg/ml mitomycin C

　手術既往のない緑内障110眼に，マイトマイシンC（MMC）を併用した線維柱帯切除術を行い，6か月後の成績を評価した。症例は原発開放隅角緑内障71眼，水晶体嚢性緑内障24眼，閉塞隅角緑内障15眼である。42眼には濃度0.2mg/ml（低濃度群），68眼には0.4mg/ml（高濃度群）のMMCを用いた。術前平均眼圧は，低濃度群21.4mmHg，高濃度群21.0mmHgであった。術後無治療で眼圧15mmHgを基準とした眼圧生存率は，低濃度群で76.2％，高濃度群で88.2％であり，両群間に有意差はなかった。低眼圧や白内障などの合併症については，両群間に有意差はなかった。以上，MMCを併用した線維柱帯切除術の6か月後の眼圧コントロールと合併症については，0.2mg/mlと0.4mg/mlのMMCの間では差がなかった。

We reviewed 110 eyes of glaucoma which underwent trabeculectomy with adjunct use of mitomycin C (MMC). The series comprised primary open-angle glaucoma 71 eyes, capsular glaucoma 24 eyes and angleclosure glaucoma 15 eyes. Low-concentration MMC of 0.2mg/ml was used in 42 eyes and high-concentration MMC of 0.4mg/ml was used in 68 eyes. The intraocular pressure (IOP) averaged 21.4mmHg in the former group and 21.0mmHg in the latter. The success rate, which was defined as IOP of 15 mmHg or less without medication 6 months after surgery, was 76.2% in the low-concentration group and 88.2% in the high-concentration group. There was no significant difference between the two groups. No significant differences were present between the two groups regarding postoperative complications including ocular hypotony and cataract. The findings show that similar hypotensive effect results 6 months after trabeculectomy whether using 0.2mg/ml or 0.4mg/ml MMC.