Practice and benefit of national standardized management of type 2 diabetes in Yulin City / 西安交通大学学报(医学版)

【Objective】 To investigate the practice and benefit of national standardized management of type 2 diabetes in Yulin City. 【Methods】 We recruited the adult type 2 diabetes patients who sought medical help at our hospital from May 2020 to October 2022 as subjects. We collected their basic information (sex and age); measured height, weight, waist and hip circumference, and blood pressure; calculated body mass index (BMI); and detected blood glucose, c-peptide, HbA1c, biomarkers, urinary microalbumin, sensory nerve conduction velocity of lower limbs, ABI, and subcutaneous and visceral fat at the time of MMC recruited and the end of six months. T test and Mann-Whitney U rank sum test were used for measurement data and χ2 test or Fisher’s exact probability method for counting data to analyze the data. 【Results】 After 6 months, the levels of fasting blood glucose, postprandial blood glucose, HbA1c, and visceral and subcutaneous fat in all the patients decreased, but the level of fasting c-peptide increased compared with the baseline (all P<0.05). Secondly, compared with the baseline, the control rate of HbA1c (35.21% vs. 13.71% ) and the comprehensive control rate (13.97% vs. 7.26% ) were both significantly increased at six months (P<0.05). Thirdly, after 6 months, the levels of fasting blood glucose, postprandial blood glucose, HbA1c, TG, TC, and UA were decreased more, while the fasting c-peptide and postprandial c-peptide were increased more in the patients of the HbA1c standard group (HbA1c<7% ) than those of the non-standard group. 【Conclusion】 The multiple benefits of blood glucose, blood lipid, uric acid and islet function can be achieved by taking type 2 diabetes patients into MMC. Meanwhile, the rates of HbA1c control and comprehensively reaching the standard are significantly increased. Therefore, MMC can explore a new way for the management of type 2 diabetic patients in this area.

Effect of Trans-PRK combined with 0.02% MMC on corneal density in patients with moderate myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the effect of 0.02% mitomycin-C(MMC)on the corneal density after transepithelial photorefractive keratectomy(Trans-PRK). METHODS: Retrospective case analysis. Selected 28 patients with 56 eyes in moderate myopia who underwent Trans-PRK surgery from January 2021 to June 2021 in our hospital. They were divided into MMC group in 28 eyes with a combination of 0.02% MMC 20s during the surgery and the control group in 28 eyes was not use MMC during the surgery. The Pentacam anterior segment analyzer was used to measured the corneal density in different diameter ranges and different thickness layers before and after surgery at 14d, and after surgery at 1 and 3mo.RESULTS: The total corneal density value of MMC group was 16.60(15.70,17.10 )before the surgery, after the surgery at 14d was 16.63(15.90,17.50 ), at 1mo was 16.57(15.10,16.70 ), at 3mo was 16.04(14.60,16.60 ). The total corneal density value of control group was 16.30(15.50,17.30 )before the surgery, after the surgery at 14d was 16.20(15.20,17.10 ), at 1mo was 16.08(14.90,16.40 )and at 3mo was 15.60(14.60,16.40 ). In the zone of 0-2mm diameter was centered on the corneal vertex, the corneal density of the two groups at 14d after the surgery was higher than those before surgery(P<0.001 ). In the zone of 2-6mm diameter, the corneal density of the two groups at 1mo and 3mo after surgery was higher than those before the surgery(P<0.001). In the zone of 6-10mm, the corneal density of the two groups at 14d, 1 and 3mo after surgery was higher than those before the surgery(P<0.001). In the layer of anterior 120 μm, the corneal density of the two groups at 1mo and 3mo after the surgery was decreased than that before surgery(P<0.01). In the middle layer, the corneal density of the two groups at 1mo after the surgery was decreased than those before surgery(P<0.01).CONCLUSION:The use of 0.02% MMC during the operation can reduce the corneal density and increase the corneal light transmittance in the early postoperative period. The occurrence and prognosis of haze can be effectively quantified by observing the changes of corneal optical density in different ranges in different time periods after operation.

Benefits from using an ankle-foot orthosis in children with myelomeningocele / Benefícios do uso da órtese tornozelo-pé nas crianças com mielomeningocele

Myelomeningocele (MMC) or spina bifida is a defect of the neural tube in which the spinal cord, its envelopes (meninges), and vertebral arches develop abnormally in the beginning of gestation, and owing to this failure of closure there appear a series of congenital defects and associated comorbidies, impairing in several aspects the functioning of the life of children with MMC. The congenital clubfoot has been found the most common orthopaedic anomaly in patients with MMC. The ankle-foot orthosis (AFO) is an orthopaedic device commonly used by these children to minimize the sequelae caused by this anomaly. OBJECTIVE: Identify the functional benefits brought about by the use of the AFO to children with MMC, as reported by their guardians. METHOD: Descriptive, transversal study. Convenience sample consisting of 25 guardians of children with MMC who were using/had used an AFO. RESULTS: Eighty percent of the guardians have reported at least one benefit brought about by the use of the AFO, among them: improvement in foot position (68%), foot growth (40%), improvement in foot balance (32%), and balance sitting position (15%). CONCLUSION: The use of the AFO by children with MMC can provide several benefits reported by their guardians.

A mielomeningocele (MMC) ou espinha bífida é um defeito do tubo neura no qual a medula espinal, seus envoltórios (meninges) e os arcos vertebrais desenvolvem-se anormalmente no início da gestação e, como consequências, temos uma série de defeitos congênitos e comorbidades associadas prejudicando a funcionalidade em diversos aspectos da vida das crianças com MMC. O pé torto congênito foi apontado como a anomalia ortopédica mais comum nos pacientes com MMC e a órtese tornozelo-pé (OTP) é um aparelho ortopédico que pode ser usado nessas crianças para amenizar as sequelas geradas por essa anomalia. OBJETIVO: Identificar os benefícios funcionais trazidos pelo uso da OTP em crianças com MMC relata-dos pelos seus responsáveis. MÉTODO: Estudo descritivo, transversal. Amostra de conveniência composta por responsáveis de 25 crianças com MMC que usavam/usaram a OTP que responderam a uma entrevista estruturada que contemplava as variáveis estudadas. RESULTADOS: Oitenta por cento dos responsáveis relataram pelo menos um benefício causado pelo uso da OTP, dentre eles: melhorou a postura do pé (68%), o pé cresceu (40%), melhorou o equilíbrio em pé (32%), melhorou o equilíbrio sentado (15%). CONCLUSÃO: O uso da OTP em crianças com MMC pode proporcionar benefícios identificados pelos responsáveis.

Topical 002% Mitomycin C for management of primary corneal-conjunctival intraepithelial neoplasia as primary therapy: A long term follow up

Background: The corneal-conjunctival intraepithelial neoplasia (CCIN) is an ocular surface neoplasia commonly found among populations exposed to strong UV light. Although surgical excision is mainstay treatment, topical Mitomycin-C (MMC) 0.02% has been tried as a sole therapeutic treatment of non- invasive Ocular Surface Squamous Neoplasia (OSSN). Aim: The aim of this study was to report the long term outcome of treatment of non invasive ocular surface squamous neoplasia with topical Mitomycin C (0.02%) as primary therapy. Materials and methods: Total six eyes of six patients with CCIN were treated with topical mitomycin C (0.02%) alone as a sole therapy. All patients received topical MMC (0.02%) four times daily as a cycle therapy of two week ON and two week OFF for 12 weeks. The patients were followed up to two years. Results: All patients showed total cure with no recurrence during 2 years follow up period. Ocular irritation and mild conjunctival hyperemia were observed in 4 eyes during treatment with MMC. There were no serious complications noted at the end of the follow-up period. Conclusion: We concluded that Topical Mitomycin C (0.02%) may be used as a sole therapeutic treatment of non invasive Ocular surface squamous neoplasia with close on going follow-up.

Clinical observation of LASEK combined with MMC in the treatment of high myopia / 中国基层医药

Objective To observe the efficacy and complication of laser subepithelial keratom ileusis (LASEK) combined with mitomycin C (MMC) in treatment of high myopia.Methods 118 cases ( 236 eyes) diagnosed as high myopia were treated by LASEK combined with MMC.The changes of vision,refractive regression,postoperation pain and haze were observed.Results 7-days after operation,all patients' post-operation relief.6-months after operation,the quantity of vision reached or exceeded BCVA were 228 cases ( 96.61％ ),average refraction wsa ( + 0.54 ± 0.24 ) D,the incidence of haze was 4.66％.Conclusion Is safe the LASEK combined with MMC in treatment of high myopia,effective,low incidence of haze.

Ahmed Valve Implantation with Adjunctive Mitomycin C and 5-Fluorouracil: Outcomes at 2 Years

PURPOSE: To evaluate the outcomes of Ahmed valve implantation in neovascular glaucoma patients who received intraoperative mitomycin C (MMC) and postoperative 5-fluorouracil (5-FU) after 24 months of follow-up. METHODS: A total of 40 eyes from 40 patients with neovascular glaucoma who received antiglaucomatous medication without previous glaucoma surgery were included in the present study. The patients were divided into 2 groups. The control group (20 eyes) underwent Ahmed valve implantation only and the study group (20 eyes) underwent Ahmed valve implantation and received intraoperative MMC and postoperative 5-FU. Failure was defined as the first occurrence of any of the following: 1) the first of 3 consecutive visits where intraocular pressure (IOP) was over 18 mmHg; 2) 20% IOP reduction from baseline; 3) the final number of topical medications was not reduced by at least two from baseline; 4) the need for additional surgery; or 5) the occurrence of a serious complication. RESULTS: In the control group, the cumulative success rate was 19.1% at 24 months. The cumulative success rate in the study group was 43.7% at 24 months. Serious complications such as endophthalmitis, valve exposure, or prolonged hypotony were not observed. CONCLUSIONS: The adjunctive use of intraoperative MMC and postoperative 5-FU with Ahmed valve implantation resulted in a high success rate and good IOP control and did not cause serious complications during the follow-up period.

Results of Trabeculectomy Using Modified Scleral Flap Suture Technique in Comparison with Standard Trabeculectomy

PURPOSE: To evaluate the efficacy of trabeculectomy using modified scleral flap suture technique METHODS: We retrospectively reviewed the medical records of 52 patients (55 eyes) who had undergone trabeculectomy from January 2003 to January 2007. Standard trabeculectomy was performed for 29 eyes of 27 patients, modified trabeculectomy for 26 eyes of 25 patients. We changed suture site of scleral flap corner about 1mm medially from original site and added tight suture to both lateral margins of scleral flap to prevent overflow in modified group. In both groups, most of patients were injected 0.1 ml of 0.02 mg/ml mitomycin-C (MMC) subconjunctivally and the others 0.1 ml of 0.04 mg/ml MMC. We evaluated intraocular pressure (IOP), complication, morphology of filtering bleb, cumulative success rates. RESULTS: Argon laser suturelysis was performed postoperatively in about half cases of both groups. The IOPs of modified group were consistently lower than those of standard group for 24 months except postoperative 1 day and 1 week. There was a significant difference of IOP at postoperative 2 months and 12 months (p<0.05). No significant difference of complications was found between two groups. The diffuse bleb with microcyst was found in 19 eyes (73%) of modified group and 17 eyes (59%) of standard group. From Kaplan-Meier survival analysis, cumulative success rates of modified group were higher than those of standard group (p<0.05). CONCLUSIONS: Trabeculectomy using modified scleral flap suture appears to give better IOP control than standard trabeculectomy.

Injection of noradrenaline to lateral hypothalamus area (LHA) inhibits small intestine myoelectric activity in rats / 基础医学与临床

Objective To study the influence of Noradrenergic systems in Lateral Hypothalamus Area (LHA) on small intestine moving. Methods The effect of noradrenalin、noradrenalin+phentolamine、noradrenalin+propolol、phentolamine on small intestines electro-activity of rats was detected by external alimentary canal electrodes and central nervous system stereo-configuration technology. Results After injecting 2 g/L noradrenaline (NE) the cyclic period of MMC extended, the ratio of the active time to the cyclic period and the number of the fast wave within the active time per minute reduced. NE inhibited the electro-activity of small intestine of rats, and the average effective time was (36.86?7.39)min. Hence injecting 5 g/L PE alone to LHA raised the ratio of the MMC active time to the cyclic period. Phentolamine presented a slight excitability on the electro-activity of small intestine of rats. Conclusion The NE in LHA showed the inhibitive myoelectric activity on small intestines, and this effect was introduced through a acceptor,The reacceptor in LHA may function in the inhibition of the electro-activity in small intestines.

Effects of astragalus polysaccharide (APS) on murine bone marrow and spleen progenitor cells in MMC-induced myleosuppression / 中国药理学通报

AIM To observe the effect of APS on bone marrow and spleen progenitor cells in MMC induced myelosuppression in mice. MEHTODS MMC 7 mg?kg -1 was injected ip on day 0, APS 100 mg?kg -1 ?d -1 was given sc in 3 regimens ① on day 0～4, ② on day 0～11,③ 12 doses in 3 weeks. RESULT APS increased the number of bone marrow progenitor cells(CFU C) of MMC treated mice 3 fold, from 1 870 ?40 per femur to 6 240 ?110 per femur on day 3.APS treatment resulted in a higher level of bone marrow CFU C at all time points from day 3 to day 18, in comparison with the control group. APS also significantly stimulated the proliferation of spleen progenitor cells on day 14 (3 fold of control) and day 18(2 fold of control) after MMC treatment, however APS had no effect on spleen progenitor cells before day 14. CONCLUSION These results demonstrate that APS enhances the proliferation and maturation of the progenitors of peripheral blood cells in MMC treated mice.

Needle Revision on Failed Filtering Blebs Using Mitomycin C

PURPOSE: To determine the success rate and complications of Mitomycin C (MMC) augmented needle revision on failed filtering blebs. METHODS: We retrospectively investigated the records of 30 patients (32 eyes) who had undergone needle revision with MMC on failed filtering blebs. A mixture of 0.02 ml of MMC (0.4 mg/ml) and 0.02 ml of 2% lidocaine (20 mg/ml) was injected subconjunctivally. 5 minutes later, needle revision was done with bented 30 gauge needle. RESULTS: The mean Intraocular pressure(IOP) decreased from 28.1+/-9.4 mm Hg before surgery to 14.7+/-6.2 mmHg at the last follow-up. The mean follow-up period after the last needle revision was 23.5+/-19.4 months. In 27 eyes (84.4%), the last IOP was less than or equal to 18 mmHg. Serious complications were not found. CONCLUSIONS: MMC augmented needle revision appears to be an effective way to revive failed filtration blebs. The incidence of complications compares favorably to that of other glaucoma related surgery.

Effect of mitomycin C instilled immediately after TUR added with low dose BCG maintenance therapy to prevent recurrence of superficial bladder cancer / 中国康复理论与实践

@#Objective To observe therapeutic effects of intravesical instillation of mitomycin C (MMC) immediately after TUR added with low dose BCG maintenance therapy to prevent recurrence of superficial bladder cancer. Methods 83 patients with superficial bladder cancer were randomly divided into two groups, 50 cases were managed with intravesical instillation of mitomycin C immediately after TUR added with low dose BCG maintenance therapy (group A), 33 cases were treated with traditional method of MMC therapy (group B) to prevent recurrence of superficial bladder cancer. Results After 12-66 months (mean 32 months) following up, 3 patients had tumor recurrence in the group A and 7 patients in the group B, the rate of tumor recurrence of the group A was 6.0% (3/50) and that of the group B was 21.2%(7/33), and there was a significantly difference between two groups (P<0.05). Side effects of the group B were obviously more than that of the group A. Conclusion Intravesical instillation of MMC immediately after TUR added with low dose BCG maintenance therapy is effective to prevent patients with superficial bladder cancer from recurrence.

The Toxic and Morphologic Effects of Mitomycin-C, 5-FU and Genistein on Rabbit Corneal Endothelium

PURPOSE: We determined the toxic and morphologic effects of the anti-proliferative drugs, mitomycin-C (MMC), 5-fluorouracil (5-FU) and genistein on rabbit corneal endothelium. METHODS: After intramuscular anesthesia, each drug of different concentrations (MMC at 0.05, 0.1, and 0.2 mg/ml; 5-FU at 5, 10, and 50 mg/ml; and genistein at 0.013, 0.027, and 0.054 mg/ml) was perfused into the anterior chamber of 54 white rabbits (108 eyes). The same amount of balanced salt solution was perfused into control eyes. The corneal thickness was measured before perfusion and 15 min, 30 min, 45 min, 1 h, and 24 h after perfusion. Corneal samples were prepared at 24 h after perfusion to determine the changes in corneal thickness and to observe morphologic changes of corneal endothelium under scanning electron microscope (SEM). RESULTS: A significant increase in corneal thickness was observed. Destruction of corneal endothelial cell structure was seen under scanning electron microscope at 24 h after perfusion with MMC at 0.2 mg/ml for 1, 3, and 5 min, and at 0.1 mg/ml for 5 min; and 5-FU at 50 mg/ml for 5 min into the anterior chamber. However, no significant difference was seen in corneal thickness or in corneal endothelial morphology at 24 h after perfusion with genistein. CONCLUSIONS: To avoid morphologic changes of the cornea, we recommend the anterior chamber perfusion of MMC at 0.1 mg/ml between 1 and 2 min, 5-FU at 10 mg/ml between 3 and 5 min, and genistein at 0.027 mg/ml for 5 min. Genistein at low concentrations showed no morphologic change in the cornea, suggesting the possible clinical use with safety.

Inhibitory Effect of Mitomycin C (MMC) on the Proliferation of Human Corneal Keratocyte

PURPOSE: To evaluate the anti-proliferative effect of mitomycin C (MMC) on human corneal keratocyte, and to investigate the cellular morphology of keratocyte according to the concentration and exposure time in vitro. METHODS: Human corneal keratocytes using endothelium-free explant method were exposed to 0.005%, 0.01%, and 0.05% concentration of MMC for 3, 5, and 10 minutes. MTT based colorimetric assay was performed to assess the inhibition of cellular proliferation, and cellular morphology was evaluated by inverted phase-contrast light microscope and electron microscope. RESULTS: Use of higher concentration MMC and prolongation of exposure time resulted in greater inhibitory effect on cellular proliferation. When exposed to 0.005% MMC for 3, 5 and 10 minutes, the survival rate of keratocyte was 100%, 95.7% and 74.0% respectively. At 0.01% MMC, the survival rate was 98.6%, 92.9%, and 66.9%. At 0.05% MMC, it was 74.0%, 73.4%, and 38.8%. Exposure to the highest concentration (0.05%) among the 3 preparations for 3 or 5 minutes showed significant inhibition of keratocyte proliferation (p<0.05), and when exposed for 10 minutes, all 3 preparations showed significant inhibition of keratocyte proliferation (p<0.05). Inverted phase-contrast light microscopy showed that human corneal keratocytes lost their adherence to the bottom of the dish and assumed round and swollen shape rather than spindle shape when exposed to higher concentration of MMC for a prolonged time. The damaged keratocytes showed the degenerative changes like cellular membrane disruption, disappearance of microvilli, enlargement of rough surfaced endoplasmic reticulum and mitochondria, and vacuole formation by electronic microscope. CONCLUSIONS: When MMC is applied to inhibit the proliferation of keratocytes involved in corneal wound healing, it seems to be a valuable application at least 0.05% concentration for 3 minutes. Further studies should be followed for the biological effect of MMC including drug toxicity associated with human corneal tissue in vivo.

The inhibiting mechanism of MMC on bladder cancer cell line EJ / 中华泌尿外科杂志

Objective To present our attempt on investigate the effect of MMC on a human bladder cancer cell line, EJ cells. Methods EJ cells were maintained under tissue culture conditions in the presence of Mitomycin C (MMC), which had a potent cytotoxic effect on these cells. The apoptosis and necrosis of EJ cells were assessed and by using flow cytometry (FCM) ,TUNEL technology and eosin exclusion assay . Results Apoptosis of bladder cancer cell line EJ could be observed within the 24 h after the use of MMC in different doses.The apoptosis peak appeared in the 24th hour and a dose dependment effect could be observed. Conclusions MMC could inhibit the growth of bladder cancer cell via inducing apoptosis and necrosis of the cells.This might enclose the therapeutic mechanism of MMC on bladder cancer.

Clinica study comparing HMVP and MVP regimens in the treatment of advanced non-small cell lung cancer / 中国癌症杂志

0.05). No significant differences were detected in the median time of remission, median survival time and 1-, 2-year survival rates between the groups. Moreover, no significant differences were detected in the grade Ⅲ～Ⅳ leukopenia, grade Ⅲ～Ⅳ thrombocytopenia, grade Ⅲ～Ⅳ nausea and vomiting and grade Ⅲ～Ⅳ constipation between the groups. Conclusions:The response rate of the MVP regimen is slightly lower than the HMVP regimen, but the HMVP regimen is not noticeably superior. It may increase the toxicity such as leukopenia, nausea/vomiting and constipation, as wellas being more expensive. In short, MVP regimen should be selected between the regimens in the chemotherapy of advanced NSCLC.

Treatment of Late Bleb Leak with Human Amniotic Membrane Transplantation

Late bleb leak after trabeculectomy is a serious and intractable complication and its frequency is increasing as antimetabolites are used in the surgery. Various modalities have been challenged in the treatment of late bleb leak but the results have not been satisfactory.Amniotic membrane is avascular tissue with thick basement membrane and rich stroma, and it can modulate wound.As it does not express HLA, it doesn t induce graft rejection. With the use of these characteristics of amniotic membrane, we report a case in which late bleb leak after trabeculectomy with MMC was successfully treated with amniotic membrane transplantation maintaining bleb function.

The Effect of MMC on Chick Lens and its Mechanism

Mitomycin C (MMC)is used in trabeculectomy to promote the intraocular pressure control, but at the same time it also seems to increase the risk of cataract. In this study, we investigated the mechanism by which MMC causes lens opacity.The whole lenses were extracted from fertilized eggs of 11~13 days and cultured in M199 media supplemented with fetal bovine serum (FBS)at 38 degrees C.Levels of Lipid peroxidation (LPO)and Glutathione (GSH)were measured 24 hours and 5 minutes after treatment with 1 mg/ml MMC for 5 minutes.Changes of lenses by MMC were examined by light microscopy, and the modification of lens proteins was analyzed by SDS-PAGE and size exclusion column. Lens opacity was induced by MMC treatment in concentration of 1 mg/ml for 5 min, and MMC treated lenses showed 3 times higher LPO level and 2 times lower GSH level than normal lenses.In ultrastructure of opaque lenses, many vacuole formations in cortical area near equatorial zone were found.In electrophoresis followed by silver staining and size exclusion column profile, high molecular weight formation of lens proteins by MMC treatment was mainly due to disulfide bond.Also, when we treated the lens with antioxidants, the extent of opacity was decreased. In this study, we demonstrated that lenses treated with MMC became opaque mainly due to oxidative stress resulting in HMW formation of lens proteins by disulfide formation as well as irreversible oxidation.

Additional Subconjunctival Low Dose 5-fluoro u racil Injection after Mitomycin C Applied Filtering Surgery in Glaucoma Patients

To evaluate the additive efficacy of postoperative low dose 5-FU subconjunctival injection, we analyzed 43 patients[43 eyes]who had undergone trabeculectomy or triple surgery with intraoperative MMC for 2.5~3min.18eyes[case group =MMC 5-FU group]of 43 eyes had postoperative low dose 5-FU injection additionally and 25 eyes[control group =MMC group]of which had only undergone intraoperative MMC. The mean[+/-SD]follow-up periods were 13.6 +/-5.3 months in MMC 5-FU group and 12.1 +/-3.6 months in MMC group.There was no statistically significant difference in preoperative IOP between the two groups[p>0.05].Mean postoperative intraocular pressures were 12.9 +/-4.2 mms of mercury in MMC 5-FU group and 13.3 +/-4.4 mms of mercury in MMC group at 12 months postoperatively[p>0.05]. Kaplan-Meier survival analysis showed that the cumulative success rates at 1.5 year were 82.6%and 87.2%in the case and control groups, respectively[p>0.05].Of the postoperative complications, corneal epithelial defect was more frequent in MMC 5-FU group[p<0.05]. In conclusion, postoperative injection of low dose 5-FU additionally did not have an additive effect on the IOP control in patients undergone MMC applied filtering surgery. We may need additional postoperative injection of higher dose of 5-FU.Or, we may need to individualize the duration of application or the concentration of intraoperative MMC to begin with.

A Case of Late Onset Bleb-Related Endophthalmitis after Trabeculectomy with Mitomycin C

Adjunctive use of Mitomycin C (MMC)in trabeculectomy has greatly improved the success rate. Trabeculectomy with MMC, however, has resulted in a cystic and thin-walled filtering bleb, which may be more susceptible to infection. Late onset bleb-related endophthalmitis developed in a glaucoma patient at 40 months after MMC trabeculectomy. Filtering bleb in this patient had been avascular, thin-walled and cystic prior to the occurrence of endophthalmitis. Patient complained of decreased visual acuity with ocular discomfort and conjunctival injection and showed a mucopurulent infiltrate within the bleb, hypopyon and vitritis. Visual acuity was hand motion. An intensive treatment included anterior chamber irrigation, lensectomy,par plana vitrectomy, intravitreal and subconjunctival antibiotics (vancomycin,gentamycin) injection and topical and systemic corticosteroid (dexamethasone) and antibiotics,which led to a resolution.

The Effect of Mitomycin C Trabeculectomy in Neovascular Glaucoma

The authors studied retrospectively the results of mitomycin C (MMC) trabeculectomy in 19 eyes with neovascular glaucoma which could be followed up more than 4 months after surgery. Twelve eyes(63%) were classified as success group and 7 eyes(37%) were classified as failure group. In the success group, the mean intraocular pressure(IOP) was significantly reduced from 52.1+/-10.1mmHg preoperatively to 10.1+/-3.8mmHg at last follow Kaplan-Meier survival analysis, cumulative success rates at 6 and 12 months intervals were 68%, 59% respectively. In the failure group, the mean IOP was reduced significantly from 51.9+/-8.1mmHg preoperatively to 26.6+/-13.4mmHg at last follow up. The mean number of medications to reduce IOP was also reduced from 2.6+/-0.5 preoperatively to 1.3+/-0.8 at last follow up. The causes for failure were inadequate IOP control in 5 eyes(26%), loss of light perception in 1 eye(5%), and reoperation to reduce IOP(5%). Complication included hypotony in 4 eyes(21%), late bleb leakage in 2 eyes(10.5%), spontaneous hyphema in 2 eyes(10.5%), cataract progression needing extraction in 2 eyes(10.5%). We think that MMC trabeculectomy may be the first choice procedure before doing cyclocyro-therapry or cyclodestructive procedure using laser.