Trabekulektomija sa mitomicinom C kod sekundarnog glaukoma nakon pars plana vitrektomije sa emulzifikovanim silikonskim uljem: tri godine praćenja

Ranko  Gvozdenović; Ivan Marjanović; Marija  Božić; Vesna  Marić; Milenko Stojković; Marija Marjanović; Elena Jordanova; Antonio Martinez

doi:10.2298/VSP200428001M

Ranko Gvozdenović University Clinical Center of Serbia, Eye Clinic, Belgrade, Serbia
Ivan Marjanović University of Belgrade, Faculty of Medicine, University Clinical Center of Serbia, Eye Clinic, Belgrade, Serbia
Marija Božić University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Vesna Marić University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Milenko Stojković University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Marija Marjanović University of Belgrade, Faculty of Medicine, Belgrade, Serbia
Elena Jordanova Clinical Hospital Center Zemun, Clinic for Internal Medicine, Department of Nephrology, Belgrade, Serbia
Antonio Martinez Clinical Research Department, Science Research and Sports, Ames, La Coruna, Spain

DOI: https://doi.org/10.2298/VSP200428001M

Keywords: glaukom, otvorenog ugla;, mitomicini;, hirurgija, oftalmološka, procedure;, ulja, slikonska;, trabekulektomija.

Abstract

Uvod/Cilj. Uklanjanje silikonskog ulja (SU) može biti povezano sa nepotpunom kontrolom intraokularnog pritiska (IOP), zbog čega su predložene različite hirurške intervencije, uključujući i trabekulektomiju primenom antiproliferativnih agenasa. Cilj rada bio je da se proceni efikasnost trabekulektomije sa mitomicinom C (MMC) u snižavanju IOP kod bolesnika sa sekundarnim glaukomom otvorenog ugla (OAG) nakon pars plana vitrektomije sa SU. Metode. Istraživanje je sprovedeno kao jednocentrična, prospektivna studija, od decembra 2014. do decembra 2019. godine, na 56 bolesnika sa nekontrolisanim povišenim IOP, nakon uklanjanja SU, koji su u tom periodu bili podvrgniti trabekulektomiji sa MMC. Krajnji ishod bio je IOP na kontrolnom pregledu nakon tri godine. Kompletan hirurški uspeh definisan je kao IOP u rasponu od 7 mmHg do 18 mmHg, bez lekova koji se primenjuju u lečenju glaukoma. Kvalifikovani uspeh definisan je kao IOP ≤ 21 mmHg, postignut uz primenu jednog ili dva topikalna leka. Rezultati. Ukupno 56 bolesnika prosečnog životnog doba od 53,6 [standardna devijacija (SD)15,5] godina imalo je srednji početni IOP od 42,3 (39,3 do 45,3) mmHg, koji se smanjio na 18,6 (od 17,9 do 19,3) mmHg, 3 godine nakon operacije (p < 0,0001). Kao potpuni uspeh klasifikovano je 17 (30,4%) očiju, kao kvalifikovani uspeh 21 (37,5%) očiju, a 18 (32,1%) očiju klasifikovano je kao neuspeh. Kod svih uspešno operisanih bolesnika broj lekova protiv glaukoma bio je značajno smanjen, sa 2,85 (SD 0,77) na 1,63 (SD 0,62), p < 0,0001. Zaključak. Trabekulektomija sa MMC može biti opcija za snižavanje IOP kod bolesnika sa sekundarnim OAG nakon pars plana vitrektomije sa emulzifikovanim SU, koji nije bio kontrolisan maksimalnom medikamentnom terapijom protiv glaukoma.

Author Biography

Ranko Gvozdenović, University Clinical Center of Serbia, Eye Clinic, Belgrade, Serbia

Doktor Medicine

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