非穿透性小梁手术联合羊膜植入物治疗原发性开角型青光眼的临床研究  

The Clinical Effect of NPTS with Amniotic Membrane Implant for Treatment of Primary Open-angle Glaucoma

作　　者：刘兆荣[1] 陈红[1] 潘玉玲[1] 

机构地区：[1]日照市人民医院眼科,山东日照276800

出　　处：《潍坊医学院学报》2005年第1期13-15,共3页Acta Academiae Medicinae Weifang

摘　　要：目的　探讨非穿透性小梁手术 (non penetratingtrabecularsurgery ,NPTS)联合羊膜植入物对原发性开角型青光眼的临床疗效。方法　对 2 2例 (2 6只眼 )原发性开角型青光眼患者进行非穿透性小梁手术联合羊膜植入物治疗。术后观察眼压、眼内反应和滤过泡并做前房角镜检查。随访时间平均 9.4个月。结果　术后视力较术前无明显变化。患者术前平均眼压 36 .84mmHg ,术后 16 .4 5mmHg ,差异有显著性 (t=5 .86 ,P <0 .0 1)。术前平均用药 3.6 4种 (2～ 4种 ) ,术后 0 .93种 (0～ 2种 ) ,差异有显著性 (秩和检验T =10 4 ,P <0 .0 1)。随访期间眼压≤ 2 1mmHg者 2 4只眼 (92 .3% ) ,无需药物治疗而眼压正常者 15只眼 (5 7.7% ) ,需用药后眼压保持正常者 9只眼(34.6 % )。结论　NPTS联合羊膜植入术能有效降低眼压 ,减少抗青光眼药物的应用 ,术后并发症少 ,是一种治疗原发性开角型青光眼的有效的新方法。Objective To evaluate the clinical effect of non-penetrating trabecular surgery (NPTS) with amniotic membrane implant in primary open-angle glaucoma(POAG).Methods NPTS with amniotic membrame implant was performed on 26 eyes of 22 patients with POAG postoperatively,the intraocular pressure (IOP),intraocular reactions and the bleb appearance were recorded,gonioscopy was performed.The mean follow-up was (9.4±3.5) months.Results The visual acuity remained stable between preoperation and postoperation.The mean IOP of patients was 36.84 mmHg preoperatively and 16.45 mmHg postoperatively;being significant difference(t=5.86,P<0.01).The mean number of drugs used for anti-glaucoma was 3.64 sorts(2～4 sorts) preoperatively,and 0.93 sorts(0～2 sorts)postoperatively;being significant difference (rank sum test T=104,P<0.01).On the last visit,in 24 eyes (92.3%) the IOP was≤21 mmHg,and among them,there were 15 eyes (57.7%) without anti-glaucoma medicine and 9 eyes (34.6%) with anti-glaucoma medicine.In 5 eyes there was a small amount of hyphema;The complications such as flat chamber,inflammation and choroidal detachment were not observed.Conclusion The elevated IOP in patients with POAG can be effectively reduced by NPTS with amniotic membrane implant,and the number of drugs used for anti-glaucoma was decreased.The postoperative complications were much less than trabeculectomys.Therefore,NPTS with amniotic membrane implant is an effective and new method for the treatment of POAG.

关 键 词：青光眼 开角型 非穿透性小梁手术 羊膜 

分 类 号：R775.2[医药卫生—眼科]