非穿透性小梁切除术后UBM随访观察  

Postoperative follow-up of non-penetrating trabecular surgery with UBM

作　　者：朱玉广[1] 朱艳[1] 王杰[1] 李秀云[1] 李兴英[1] 

机构地区：[1]潍坊医学院附属医院眼科中心,261031

出　　处：《眼科研究》2008年第2期141-144,共4页Chinese Ophthalmic Research

摘　　要：目的研究超声生物显微镜（UBM）在非穿透性小梁切除术（NPTS）后随访的意义。方法对21例28～51岁开角型青光眼患者进行NPTS联合丝裂霉素C（MMC）及羊膜植入治疗，在术后1～18个月，UBM观察滤过泡的形态、形成液间腔的大小、剩余小梁膜的厚度及羊膜的变化。结果所有病例UBM下均形成前部的液间腔，随访18个月，其边缘逐渐钝化不规则，体积逐渐缩小，差异有统计学意义。角巩膜小粱带逐渐粗糙，其厚度测量差别较大。羊膜术后9个月左右融解，无明显后部液间腔存在。结论NPTS联合MMC及羊膜植入能有效降低眼压，远期效果良好。UBM适合于NPTS的随访，羊膜在NPTS中无明显的抑制纤维增生作用。Objective Non-penetrating trabecular surgery （NPTS） is a new filtrating surgery without opening in ternal trabecular structures. The purpose of this paper was to evaluate the effect of NPTS with mitomycin C （MMC） and amniotic membrane （AM） implantation in patients with primary open-angle glaucoma （POAG） and assess the validity of ultrasound biomicroscopy （UBM） in postoperative follow-up of NPTS. Methods NPTS with MMC and AM implantation was performed on 30 eyes of 21 patients with POAG aged 28 - 51 years. Intraocular pressure （IOP） ,visual acuity and the filtrating bleb appearance were recorded. UBM of the sclerectomy site was performed 1,3,6,9,12 and 18 months after surgery. Some parameters including conjunctival filtrating bleb appearance, condition of suprascleral aqueous lake, the thickness of residual trabeculocorneal membrane and condition of amniotic membrane were assessed. Results lOP of postoperation （ 15.7± 3.7 ） mmHg was significantly lower than that of preoperation （ 37.3± 5.9） mmHg in all patients（ t = 4.82, P 〈 0.01 ）. At the end of follow-up,lOP was controlled effectively in all patients. There was no significant difference in visual acuity between preoperation and 1 month postoperation （χ^2 = 8. 814 ,P = 0. 266）. The functional filtrating bleb was existed in 14 eyes（46. 67% ） during the follow-up. The margin of anterior aqueous lakes was rough gradually. In 1 - 18 months after operation, the volume of anterior aqueous lakes was changed significantly and contracted gradually in comparison with preoperation （ F = 38. 885, P = 0. 000）. Amniotic membrane implant was not degradated until 9 months in postoperation and the transparent liquid space was not found under the scleral flap. The residual trabeculocorneal membrane was roughened eccentricly. Conclusion NPTS with MMC and AM implant can effectively reduce IOP in patients with POAG in long-term. UBM is a new noninvasive method for postoperative observation of NPTS. AM has not the anti-fihrotic pro

关 键 词：非穿透性小梁切除术 超声生物显微镜 羊膜 丝裂霉素C 

分 类 号：R779.6[医药卫生—眼科]