巩膜下小湖成形小梁切除术并可调整缝线治疗闭角型青光眼的临床观察  

Clinical observation of subscleral lake shaping trabeculectomy with adjustable sutures in angle-closure glaucoma

作　　者：张辉 

机构地区：[1]河南省南阳市眼科医院,473014

出　　处：《眼科新进展》2009年第3期221-223,共3页Recent Advances in Ophthalmology

摘　　要：目的观察巩膜下小湖成形小梁切除术并可调整缝线治疗闭角型青光眼的临床疗效。方法对420例(488眼)50岁以上闭角型青光眼患者进行随机分组,210例(240眼)作为治疗组,术中做深层巩膜切除、巩膜下小湖内注透明质酸钠、巩膜瓣切口两侧做2根可调整缝线,210例(248眼)作为对照组,做传统小梁切除术。分析比较2组术后眼压、前房深度、滤过泡及术中、术后并发症情况。结果术后治疗组Ⅰ度浅前房8眼(3.3%),对照组Ⅰ度浅前房36眼和Ⅱ度浅前房19眼(共22.2%),2组相比差异有显著统计学意义(P<0.01)。随访1a,治疗组功能性滤过泡213眼(88.8%),较对照组功能性滤过泡159眼(64.1%)多(P<0.05);以不用降眼压药物眼压控制在21mmHg(1kPa=7.5mmHg)以下为手术成功标准,治疗组手术成功率为93.3%(224眼),较对照组70.6%(175眼)高(P<0.05)。结论巩膜下小湖成形小梁切除术并可调整缝线能有效地降低眼压,减少术后浅前房的发生,提高手术成功率。Objective To investigate the clinical effect of subscleral lake shaping trabetculectomy with adjustable sutures in angle-closure glaucoma.Methods The 420 angle-closure glaucoma patients （488 eyes） with more than fifty years old were randomly divided into control group （210 cases,248 eyes） underwent trabetculectomy and experimental group （210 cases,240 eyes） underwent subscleral lake shaping trabetculectomy combined with adjustable sutures.Postoperative intraocular pressure,anterior chamber depth,filtration bubble and complication were compared between two groups.Results In the experimental group,there were 8 eyes（3.3%）with Ⅰ degree shallow anterior chamber after operation,while 36 eyes with Ⅰ degree and 19 eyes with Ⅱ degree（total 22.2%）in control group（P〈0.01）.Following up for one year,there were 213 eyes（88.8%）with functional filtration bubble in the experimental group,while 159 eyes（64.1%） in control group（P〈0.05）;According to the standard of operative success-intraocular pressure less than 21 mmHg（1 kPa=7.5 mmHg） without drugs,there were 224 eyes（93.3%） success in experimental group,while 175 eyes（70.6%） in control group（P〈0.05）.Conclusion Subscleral lake shaping trabetculectomy with adjustable sutures can effectively reduce intraocular pressure,decrease post-operative shallow anterior chamber,and increase operative success.

关 键 词：巩膜下小湖成形 小梁切除术 可调整缝线 闭角型青光眼 

分 类 号：R775.2[医药卫生—眼科]