大疱性角膜病变作为使用丝裂霉素C小梁切除术后并发症
Bullous keratopathy as a complication of trabeculectomy with mitomycin C作者机构：Aschaffenburg Eye Center Elisenstrasse 32 63739 Aschaffenburg Germany
出 版 物：《世界核心医学期刊文摘(眼科学分册)》 (Digest of the World Core Medical Journals)
年 卷 期：2006年第4期
页 面：45-45页
学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学]
主 题：丝裂霉素 角膜内皮 抗癌抗菌素 眼前房 小梁切除术 角膜病变 大疱性 并发病 疾病 并发症
摘 要：Background: The routine use of mitomycin C to enhance glaucomatous filtering surgery has found wide acceptance. Complications of the application of mitomycin C have been repeatedly noticed. We now report a previously undescribed complication showing a toxic effect of mitomycin C to the corneal endothelium. Methods: Patients underwent routine trabe culectomy with mitomycin C. Following surgery, the eyes were examined by biomicroscopy and specular microscopy of the corneal endothelium. Results: In two cases, we observed a partial decompensation of the corneal endothelium resulting in a well-demarcated clear zone of the cornea and a second zone with thickening of the cornea and a bullous keratopathy adjacent to the filtering bleb. The specular microscopy showed marked irregularities of the endothelial cells and areas of necrosis in those parts of the cornea close to the filtering bleb. Conclusions: The two cases described here demonstrate that if the corneal endothelium is already compromised before surgery, the application of mitomycin C may have an additional toxic effect on the endothelium and may result in a partial bullous keratopathy. Surgeons should be aware of this complication.
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