隧道式小切口小梁切除术治疗青光眼的临床观察  

Clinical observation on trabeculectomy through small tunnel incision in treatment of glaucoma

作　　者：吴晓红[1] 尹忠贵[1] 王巍[1] 朱伟林[1] 李赵霞[1] 

机构地区：[1]上海市浦东新区人民医院眼科,201200

出　　处：《眼科新进展》2007年第5期378-379,385,共3页Recent Advances in Ophthalmology

摘　　要：目的观察隧道式小切口小梁切除术治疗青光眼的临床效果。方法对年龄大于40岁的原发性闭角型青光眼及开角型青光眼33例40眼,分别行隧道式小切口小梁切除术(改良组:16例20眼)和标准小梁切除术(对照组:17例20眼),并随访12个月,比较2种手术前后眼压、手术成功率、术后滤过泡形成和并发症情况。结果2组术后5d、12个月的平均眼压:改良组(11.47±3.08)mmHg(1kPa=7.5mmHg)、(15.80±2.81)mmHg;对照组(11.32±2.53)mm-Hg、(15.15±2·67)mmHg,均明显低于术前改良组(25.88±12.02)mmHg(P<0.001、0.01);对照组(22.58±12.52)mmHg(P<0.01、0.05)。2组间术前、术后5d、12个月的平均眼压,以及术后12个月的手术成功率(改良组80%、对照组75%)、术后功能滤过泡占各组总例数的比率(改良组85%、对照组75%)和术后并发症发生率(改良组25%、对照组30%)比较,差异均无统计学意义(P>0.05)。结论与标准小梁切除术相比,隧道式小切口小梁切除术效果相同,小切口使术式更安全便捷,且减少了对结膜筋膜囊的损伤。Objective To observe the clinical effect of trabeculectomy through small tunnel incision in treatment of glaucoma. Methods Thirty-three patients （40 eyes ） with primary closed angle glaucoma and primary open angle glaucoma were treated with small tunnel incision trabeculectomy （ modified group,20 eyes） and standard trabeculectomy （ control group, 20 eyes）, the follow-up time was 12 months. The intraocular pressure （IOP） before and after treatment, successful rate, filtered bleb formation and complications after treatment were analyzed and compared between two groups. Results The mean IOP at 5 days and 12 months after treatment in modified group and control group were （ 11. 47 ± 3.08 ） mmHg （ 1kPa =7.5 mmHg） ,（ 15.80 ±2. 81 ）mmHg and （ 11. 32 ± 2. 53）mmHg, （ 15.15 ± 2.67） mmHg,which were distinctly lower than that before treatment （modified group： （ 25.88 ± 12.02 ） mmHg,P 〈 0. 001,0.01 ; Control group： （22.58 ± 12.52） mmHg,P〈0.01 ,0.05） ,but there were no significant difference between two groups in mean IOP before treatment and at 5 days, 12 months after treatment. There were no significant difference between two groups in successful rate （ modified group 80% , control group 75% ）, formation rate of functional filtered blebs （modified ,group 85%, control group 75% ） and complications （modified group 25% , control group 30% ） （ P 〉 0.05 ）. Conclusion Compared with standard trabeculectomy,the clinical effect of trabeculectomy through small tunnel incision is identical and even safer to operate bath less injury.

关 键 词：青光眼 小梁切除术 小切口 隧道切口 

分 类 号：R775[医药卫生—眼科]