目的:通过在青光眼滤过术中应用环胞霉素A(CsA)与5-氟尿嘧啶(5-FU)的对照研究,评价环胞霉素A(CsA)与5氟尿嘧啶(5-FU)用于青光眼滤过术的临床疗效及应用价值。方法:采取随机对照临床试验研究方法,将60例90眼难治性青光眼患者分为两组。每组30例45眼,一组患者术中应用20g/LCsA溶液于巩膜瓣下及结膜瓣下,另一组用25mg/mL5-FU溶液浸润巩膜瓣上及结膜瓣下,共4min。术后随访15mo。结果:术后第15mo末,CsA组和5-FU组功能性滤过泡的累积百分率分别为(81.25±10.13)%和(61.75±8.12)%,两组差异有显著性(P<0.05)。CsA组累计完全成功率与条件成功率分别为(81.25±10.13)%,(92.62±3.38)%与5-FU组的(61.75±8.12)%,(79.37±6.12)%,差异有显著性(P<0.05)。CsA对眼部毒副作用比5-FU少,且无长期严重并发症。结论:CsA应用于青光眼滤过术比5-FU更加安全有效。

AIM:To evaluate the clinical efficacy and application value of Cyclosporin A (CsA) and 5-Fluorouracil (5-FU) in glaucoma filtration surgery through comparing the results of CsA and 5-FU in the surgery.METHODS:Sixty cases(90 eyes)with intractable glaucomatous patients were randomly studied by treatment with CsA or 5-FU following trabeculectomy,each group consisting of 30 cases(45 eyes).20g/L CsA and 25mg/mL 5-FU were used for treatment of each group respectively for 4minutes.The follow-up was ranged 15 months.RESULTS:The 15th month life-table success rate of functional bleb formation was (81.25±10.13)% in CsA group and (61.75±8.12)% in 5-FU group,the difference being statistically significant(P<0.05).The 15th month life-table complete and qualified success rates were (81.25±10.13)% and (92.62±3.38)% in CsA group,(61.75±8.12)% and (79.37±6.12)% in 5-FU group,the difference being statistically significant(P<0.05).Toxic and side effcts induced by CsA were more rare than 5-FU,No severe complications were found.CONCLUSION:CsA is more safe than 5-FU in glaucoma filtration surgery.

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