难治性青光眼小梁切除术中应用生物羊膜与丝裂霉素C治疗的观察  

A Clinical Comparative Observation of Biotic Amniotic Membrane with Mitomycin C Applied in refractory Glaucoma Trabeculectomy

作　　者：哈少平[1] 范文燕[1] 杨巧玲[1] 哈文静[1] 

机构地区：[1]宁夏回族自治区人民医院眼科,银川750021

出　　处：《中国实用眼科杂志》2008年第8期828-830,共3页Chinese Journal of Practical Ophthalmology

基　　金：宁夏自治区科技攻关项目（K200612）

摘　　要：目的观察生物羊膜与丝裂霉素C，应用于青光眼小梁切除术中治疗难治性青光眼的临床疗效。方法采用随机对照的方法，将临床收治的55例（73只眼）难治性青光眼患者分为羊膜组（33只眼）和丝裂霉素组（40只眼），前者施行小粱切除术联合巩膜瓣下生物羊膜植入术，后者在术中一次性应用丝裂霉素C，浓度为0．2加．4mg／ml，时间2-4min，随访3月至1年，比较两种手术方式的临床疗效。结果术后与术前相比：两组眼压均明显降低（P值均〈0.001）；术后1-2周内羊膜组视力下降者仅占20％，而丝裂霉素组视力下降者占45％，两组间差异有统计学意义（P〈0.05）。术后并发症：羊膜组副反应小。引起的并发症主要有术后浅前房；丝裂霉素组引起的并发症主要有薄壁滤过泡、滤过泡渗漏、低眼压性脉络膜脱离。结论小梁切除术中生物羊膜的应用，可有效地防止难治性青光眼滤过泡瘢痕组织的形成，且并发症较丝裂霉素少，是治疗难治性青光眼安全、有效的手术方法。Objective To observe the results of trabeculectomy with biotic amniotic membrane （AMT） or mitomycin C （MMC） in the treatment of the refractory glaucoma. Methods In a randomized control clinical trial, 73 eyes of 55 patients with refractory glaucoma were underwent trabeculectomy with AMT （33 eyes） or MMC （40 eyes）.The former was trabeculectomy with AMT transplanted under the scleral flap; the latter was Intraoperatively administered with MMC , 0.2mg/ml via a sponge for 2-4minutes. The fol- low-up was 3 months- 1 year, comparing the effect of two kinds of surgery. Results Comparing the postoperative with preoperative, the intraocular pressure （IOP） of the two groups significantly declined （P 〈0.01 ）. The decrease of visual acuity was seen in 45% in MMC group,whereas that was only 20% in AMT group within 1 to 2 weeks.The difference was remarkable between the two groups （P 〈0.05 ）.The postoperative complications induced by AMT were rare, mainly involving the shallow anterior chamber, whereas those by MMC involving were thin wall bleb, bleb leaking, hypotonous maculopath and so on. Conclusions Application AMT in trabeculectomy can prevent the bleb scar formation and the complications were more rare those that of MMC, It is a useful and safe method for treatment of refractory glaucoma.

关 键 词：难治性青光眼 小梁切除 生物羊膜 丝裂霉素 

分 类 号：R775.05[医药卫生—眼科] R775[医药卫生—临床医学]