黏弹物质小管切开术联合薇乔缝线植入治疗开角型青光眼  

Study on the effect ofviscocanalostomy with polyglactin on open-angle glaucoma

作　　者：蔡洁[1] 季建[2] 

机构地区：[1]广西医科大学第一附属医院眼科,广西530021 [2]天津医科大学眼科中心,天津300070

出　　处：《中国实用眼科杂志》2009年第5期448-451,共4页Chinese Journal of Practical Ophthalmology

基　　金：本课题为天津医科大学科学基金项目（基金号：2002ky32）

摘　　要：目的探讨黏弹物质小管切开术联合薇乔缝线植入治疗开角型青光眼的可行性及疗效评价。方法对17例（27只眼）药物不能控制的中、晚期开角型青光眼患者进行黏弹物质小管切开术联合薇乔缝线植入，随访12个月，术后观察视力、眼压、眼内反应及超声生物显微镜（UBM）检查。结果（1）术前患者的眼压平均为（30．91±14．06）mmHg；术后第1天、1周、1个月、6个月和12个月平均眼压分别为（7．09±4．78）、（8．38±3．81）、（14．84＋6．51）、（13．38±3．40）和（16．08±3．24）mmHg，均较术前有显著性差异（均P〈0．01），至术后1个月以后患者眼压基本趋于稳定。（2）术后12个月，需要和不需要药物治疗，眼压〈21mmHg的成功率为95．7％（22／23），无需药物治疗眼压〈21mmHg的完全成功率为56．5％（13／23）。结论黏弹物质小管切开术联合薇乔缝线植入可有效地降低眼压，术后并发症少，对视力无明显影响，且薇乔缝线易于获取．价格便官．是一种具有良好府用前景的抗青光眼新方法。Objective To evaluate the feasibility and efficacy of viscocanalostomy with polyglactin on open-angle glancoma.Methods 27 eyes of 17 cases with medically uncontrolled open-angle glaucoma underwent viscocanalostomy with polyglactin.Clinical manifestation,IOP,visual acuity and drugs used for anti-glaucoma,post-operatively,were also analyzed.And all patients were undertook ultrasound biomicroscopy （UBM）to evaluate the surgical site.Results （ 1 ）the mean IOP preoperatively was（30.91± 14.06）mmHg, decreased to （7.09±4.78）mmHg at the first day after the modified Stegrnaun surgery, （8.38± 3.81 ）mmHg at the days 7, （ 14.84±6.51 ）mmHg at the month 1, （ 13.38±3.40 ）mmHg at the month 6 and（ 16.08± 3.24 ）mmHg at the month 12, respectively.There was significantly difference in the lOP between at every time-point postoperatively and preoperatively. （2）At the months 12, the successs rate, defined as an IOP below 21 mmHg with and without medication, was 95.7%（22/23 ）, and the complete successs rate, defined as an IOP below 21 mmHg without medication,was 56.5% （ 13/23）.Conclusions Viscocanalostomy with polyglactin could effectively lower the IOP. The postoperative complications were much fewer, with the unchanged visual acuity.And the polyglactin sutures were cheap and easy to obtain.Therefore, it is a very hopeful and practicable new anti-glaucomalous surgery.

关 键 词：开角型青光眼 非穿透小梁手术 薇乔缝线 

分 类 号：R775.2[医药卫生—眼科] R815[医药卫生—临床医学]