中晚期原发性开角型青光眼小梁切除术后视野进展的情况  

Visual field progression in moderate and severe primary open angle glaucoma patients after trabeculectomy

作　　者：王纹姬[1] 袁援生[1] 

机构地区：[1]中国云南省玉溪市人民医院眼科昆明医学院第六附属医院,653100

出　　处：《国际眼科杂志》2009年第8期1502-1504,共3页International Eye Science

摘　　要：目的:利用平均缺损(mean deviation,MD)、模式标准差(pattern standarcd deviation,PSD)研究中晚期原发性开角型青光眼小梁切除术后视野进展的情况。方法:收集小梁切除术后的原发性开角型青光眼47例60眼,利用进展期青光眼干预研究(AGIS)计分标准进行视野评分,将观察对象分为两组,视野进展组和视野平稳组。通过改良的HPA(Hodapp-Parrish-Anderson)国际视野分期法,根据术前视野将两组观察对象分为早、中、晚期。观察两组中晚期术后MD,PSD与术前相应指标的变化,术后随访MD,PSD之间的变化;两组之间进行比较。结果:小梁切除术后视野平稳组早期,MD绝对值下降明显,与术前相比具有极其显著性差异(P<0.01);PSD升高,与术前相比具有显著性差异(P<0.05)。小梁切除术后视野进展组早期,MD绝对值下降,与术前相比无显著性差异(P>0.05);PSD上升,与术前相比具有显著性差异(P<0.05)。随着随访年限的延长,两组术后随访MD绝对值有缓慢上升趋势,视野进展组的均值较视野平稳组高,但PSD两组间比较变化不大。结论:中晚期原发性开角型青光眼小梁切除术后,早期效果好,随着随访年限的延长,视野有恶化趋势。AIM： To investigate the condition for visual field progression after trabeculectomy in moderate and severe primary open angle glaucoma by mean defect （MD）, pattern standard deviation（PSD）. METHODS： Forty-seven cases （60 eyes） after trabeculectomy in primary open angle glaucoma were selected. Subjects were divided into two groups： visual field progressive group and visual field steady group with the Advanced Glaucoma Intervention Study （AGIS） scoring method. Two groups were classified as early stage, moderate stage and severe stage by visual fields before operation with the Modified Hodapp-Parrish-Anderson Visual Fields Grading System. To observe two groups moderate and severe change of MD and PSD in postoperation compared with that in the preoperation. Then, a comparison between two groups was maked. ~ RESULTS： Visual field steady group： absolute value of MD after trabeculectomy in early stage dramatically dropped compared with preoperation , and there was statistically significant difference （ P 〈 0. 01 ）. PSD rised compared with preoperation with obvious turn for the better （ P 〈 0.05）. Visual field progressive group： absolute value of MD after trabeculectomy in early stage were lower than preoperation , and there was no statistically significant difference （ P 〉 0.05）. PSD increased compared with preoperation with obvious turn for the better （P 〈 0.05）. As follow-up years prolonging, both of the MD ascended,and visual field progressive group was higher than visual field steady group in postoperation. But there was no significant difference in two groups in PSD. CONCLUSION： The moderate and severe primary open angle glaucoma after trabeculectomy appears good effect in early stage, but with the follow-up extended, field of vision shows deteriorating trend.

关 键 词：原发性开角型青光眼 小梁切除术 视野进展 平均缺损 模式标准差 

分 类 号：R779.6[医药卫生—眼科]