“三明治”式人羊膜移植治疗难治性青光眼疗效评价  

Efficacy evaluation using sandwich style human amniotic membrane transplantation for refractory glaucoma

作　　者：陆炯[1] 邢茜[1] 徐明[1] 孟逸芳[1] 顾正[1] 

机构地区：[1]中国江苏省常熟市第二人民医院眼科,215500

出　　处：《国际眼科杂志》2009年第6期1087-1089,共3页International Eye Science

摘　　要：目的:探讨小梁切除联合"三明治"式羊膜植入治疗难治性青光眼并运用超声生物显微镜(ultrasound biomicroscopy,UBM)评价其疗效。方法:对完成追踪观察的49例(50眼)难治性青光眼患者施行小梁切除后,术中巩膜瓣下及结膜瓣下植入人羊膜(即三明治式),以保持滤过道通畅。结果:术后随访6～12mo,85.2%的患者完成了整个随访,术后12mo时,眼压由术前的46.38±0.12mmHg降至18.86±3.80mmHg(t=48.56,P<0.05),观察术前、术后眼压比较差异均有显著意义,功能性滤过道形成率为88.6%,无排斥反应和严重并发症,UBM下所有病例术后均形成前部的透明液间腔。随访期间巩膜池前部体积无明显变化,平均宽1.976±0.618mm,高0.295±0.137mm。羊膜在术后9mo左右融解后后部巩膜池无明显液间池存在,但滤过道通畅。结论:"三明治"式羊膜植入是治疗难治性青光眼的安全有效术式。UBM适合于通过影像对该手术疗效进行长期随访。AIM： To evaluate of using ultrasound biomicroscopy （UBM） in trabeculectomy combined with sandwich style human amniotic membrane transplantation for refractory glaucoma. METHODS： We analyzed retrospectively 49 patients （50eyes） with refractory glaucoma, who undertaken trabeculectomy and human amniotic membrane transplantation between scleral and conjunctional flap （sandwich style） to maintain filtration trap. RESULTS ：The follow-up time was 6-12 months, 85.2% of patients received whole follow-up, the intraocular pressure decreased from 46.38 ± 0.12mmHg before operation to 18.86 ± 3.80mmHg （t= 48.56, P〈 0.05） 12 months after operation. The lOP before and after surgery had significant differences. 91. 7% had functional filtration trap. No one had rejection and serious complications. All patients formed anterior liquid cavity in UBM, in followup time the cavity of anterior scleral pool had no obvious changes, the average width was 1. 976 ± 0. 618mm, the height 0. 295 ± 0. 137mm. About 9 months postoperation the amniotic membrane had melt, in UBM there had no liquid cavity after scleral pool, but the filtration trap was good. CONCLUSION： Sandwich style human amniotic membrane transplantation is safe and effective for refractory glaucoma. UBM is useful in long-term followup after surgery.

关 键 词：难治性青光眼 羊膜 移植 小梁切除术 超声生物显微镜 

分 类 号：R779.6[医药卫生—眼科]