小梁切除联合双瓣下甘油保存羊膜植入术治疗闭角型青光眼的临床观察  

Clinical Efficacy of Trabeculectomy Combined with Sub-flap Implantation with Amniotic Membrance Preserved in Glycerin For Angle Closure Glaucoma

作　　者：张伊晖[1] 崔巍[1] 

机构地区：[1]内蒙古自治区医院眼科,内蒙古呼和浩特010017

出　　处：《内蒙古医学杂志》2009年第3期273-276,共4页Inner Mongolia Medical Journal

基　　金：内蒙古科技厅攻关项目(20050615)

摘　　要：目的：探讨甘油保存羊膜在双瓣下小梁切除术中的抗瘢痕粘连作用。方法：采用随机对照临床实验方法，施行标准的小梁切除术。将39例（52眼）确诊的闭角型青光眼患者分为移植组20例（26眼），对照组19例（26眼）。移植组术中在巩膜瓣、结膜瓣下行羊膜植入术，对照组未行羊膜植入术。术后随访3个月～1年，观察术后视力、滤过泡、前房深度、眼压及术后并发症等情况。结果：术后6个月随访移植组与对照组由术前眼压（30．73±7．92）mmHg、（29．85±7．92）mmHg降至术后（14．12±4．56）mmHg、（17．50±5．26）mmHg，术后两组眼压比较差别有统计学意义（P〈0．05）；功能性滤过泡移植组21眼（80．8％），对照组14眼（53．8％），两组间差异有统计学意义（P〈0．05）；手术成功率：移植组与对照组手术成功率分别为96．2％、76．9％，两组间均有统计学意义（P〈0．05）；视力：移植组术后视力好于对照组（P〈0．05）；并发症：移植组与对照组无显著性差异（P〉0．05）。结论：羊膜移植可减少滤过道瘢痕的形成，显著提高青光眼滤过术的成功率，可推广应用。Objective：To study the antiadhension effect of amniotic membrance preserved in glycerin on trabeculectomy. Methods： 39 cases of angle closure glaucoma undergoing trabeculectomy were dividied into two groups： implantation group（26 eyes of 20 cases） with implantation of amniotie membrance under scleral flap and conjunctival flap, control group（26 eyes of 19 cases） without implantation. Followed up between 3 months and 1 year, the posteoperative visual acuity, filtering , the anterior chamber depth, intraocular pressure and complications were evaluated. Results： The intraocular pressure decreased from preoperative 30.73 ± 7.92 mmHg to postoperative 14.12 ± 4.56 mmHg in implantation group, and from preoperative 29.85 ± 7.92 mmHg to postoperative 17.50 ± 5.26 mmHg in control group, the difference was significant（P 〈 0.05）. The functional filtering showed in 21 eyes in implantation group and 14 eyse in control group and the success rate of surgery in implantation group and control group was respectively 96.2% and 76.9%, showing markedly difference（P 〈 0,05）. The visual acuity in implantation group was better than that in control group（P 〈 0.05）. There was no significant difference in complications between two group（ P 〉 0.05）. Conclusion： The implantation with amniotic membrance may lessen the scar in filtering passage and improve the success rate of trabeculectomy. The technique should be recommended.

关 键 词：青光眼 羊膜 移植 

分 类 号：R775[医药卫生—眼科]