冰冻羊膜在非穿透小梁术中的应用  

Application of preserved human amnion in non-perforating trabecular surgery

作　　者：钟白丽[1] 侯宝杰[1] 吴海洋[1] 陶海[1] 王伟[1] 

机构地区：[1]武警总医院眼科,北京100039

出　　处：《武警医学》2007年第7期522-524,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的观察评价冰冻保存羊膜在非穿透小梁术中替代透明质酸凝胶植入物的临床疗效。方法对9例原发性开角型青光眼患者的16眼施行非穿透小梁手术,术中在巩膜瓣下嵌入羊膜,并随机对其中7眼术中联合应用丝裂霉素C,随访6个月。结果16眼术前平均眼压27.94 mmHg,术后平均降至15.29 mmHg,(t=12.05,P<0.01),术后与术前比较差异有统计学意义;在术中使用丝裂霉素C者,术后平均眼压14.84 mmHg,,未使用丝裂霉素C者,术后平均眼压10.95 mmHg,两者比较差异无统计学意义。16眼中仅1眼出现眼压失控,须二次手术加药物控制眼压外其余15眼均为功能滤过泡,无须加用降眼压药。结论冰冻保存羊膜是一种有前景的用于非穿透小梁术中的替代植入物,可安全有效地降低眼压,手术并发症少而轻。术中加或不加丝裂霉素C无确切意义。Objective To evaluate the clinical efficacy of non- perforating trabecular surgery （NPTS） by preserved human amnion implantation instead of hyaluronic acid gelatin.Methods Nine patients（ 16 eyes） with primary open angle glaucoma （FOAG） underwent NPTS by preserved human ananion implantation, the ananion was embedded under the sclerotic flap. Mitomycin C （MMC） was used in 7 eyes randomly in the surgery. The mean follow - up period was 6 months. Results The mean intraocular pressure （IOP） was decreased from 27 . 94 mmHg before the surgery to 15.29 mmHg after the surgery,with a significance difference （ t = 12.05, P 〈 0.01）.The mean IOPs in the MMC group and the control group were 14.84 mmHg and 10.95 mmHg, respectively, without significant difference （ t = 0.34, P 〉 0.05）. Only one of 16 eyes＇ IOP was out of control after the surgery, which needed a second surgery with drug. Other 15 eyes obtained functional filtering through alveolus and needed no extra treatment. Conclusions With fewer complications, preserved human amnion is a promising implant for NPTS. It achieves a satisfactory postoperative IOP safely and effectively. There is no significant difference between the outcomes of NPTS with and without MMC.

关 键 词：青光眼 小梁手术 羊膜 丝裂霉素C 

分 类 号：R775.2[医药卫生—眼科]