复合角巩膜瓣下透明角膜切除治疗原发性青光眼  

Combinating transparent cornea resection under corneoscleral flap treating for primary glaucoma

作　　者：陈忠平[1] 刘二华[1] 陈恩亚[1] 

机构地区：[1]南华大学附属第一医院眼科,湖南衡阳421001

出　　处：《眼外伤职业眼病杂志》2009年第10期761-764,共4页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的探讨复合角巩膜瓣下透明角膜切除术治疗原发性青光眼的疗效。方法对接受滤过性手术的原发性青光眼176例(243眼),随机分为2组:实验组91例(123眼),采用复合角巩膜瓣下透明角膜切除术;对照组85例(120眼),采用复合式小梁切除术。观察两组术后1d、3d、1周、2周、1月、3月、6月、1a、2a的眼压及并发症等。结果两组术后第1周内眼压差异有统计学意义,实验组眼压高于对照组(P<0.01),尔后差异无统计学意义。两组术后前房积血、浅前房、脉络膜脱离的发生率,住院时间等实验组低于对照组,差异有统计学意义(P<0.05)。功能性滤过泡比率,术后1～3月,实验组高于对照组,手术半年后,两组相当。结论复合角巩膜瓣下透明角膜切除术手术方法简单,术后并发症少,术后恢复快,且可以达到与复合式小梁切除术同样的远期降眼压效果及滤过作用。Objective To study the therapeutic effect for the patient of primary glaucoma treated by combinating transparent cornea resection under corneoscleral flap. Methods From June 2004 to May 2007,176 cases （243 eyes） of primary glaucoma receiving filtered operation in our department, randomization to two groups： experiment group with 91 cases （ 123 eyes） , received combination transparent cornea resection under comeosclera flap; control group with 85 cases （120 eyes）, received combination trabeeulectomy. Intraocular pressure and post operation complication were be observed post operation at 1 day, 3 days, 1 week, 2 weeks, 1 month, 3 months, 1 year and 2 years. Results The intraocular pressure was significant difference between the two groups in the first week post operation （ P 〈 0.01 ）, the experiment group was higher than the control group; there was no significant difference thereafter. Early postoperative, control group was observed higher rates of hyphema, shallow anterior chamber, choroidal detachment and longer length of stay （P 〈 0.05）. Within 3 months, the ratio of functionality bleb was higher in the experiment group, there was no significant difference between the two groups after half a year. Conclusion The operation of combination transparent cornea resection under eomeosclera flap is much simple. It has less postoperative complications and its postoperative recovery is fast. It can reach the same long-term decreasing intraocular pressure level and filtered effective as combination trabeculectomy.

关 键 词：复合角巩膜瓣下透明角膜切除术 复合式小梁切除术 原发性青光眼 眼压 并发症 

分 类 号：R779.6[医药卫生—眼科]