小梁切除联合注射透明质酸钠的术后效果观察  

The effect of combination of trabeculectomy and sodium hyaluronate injection

作　　者：郝磊[1] 付晶[1] 牟大鹏[1] 王怀洲[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科学与视觉科学重点实验室,北京100730

出　　处：《临床眼科杂志》2011年第1期22-26,共5页Journal of Clinical Ophthalmology

摘　　要：目的研究可注射式交联透明质酸钠在小梁切除术后早中期的效果。方法将患者随机分成两组,每组25例(25只眼),其中一组在术毕滤过泡下注射交联透明质酸钠,另一组常规缝合结膜。观察术后并发症;在1周、1个月、3个月、6个月的眼压;各相应时间裂隙灯照像并进行评分;用超声生物显微镜(UBM)检查滤过通道、滤过泡内反射和滤过泡形态。结果试验组在术后早期并发症较少。术后1周和1个月两组眼压没有统计学差异。术后3个月试验组眼压(10.8±3.8)mmHg,对照组(13.8±6.3)mmHg(P=0.047);6个月试验组眼压(11.6±4.9)mmHg,对照组(15.2±5.2)mmHg(P=0.037)。试验组眼压控制良好的比率优于对照组。在各个时点裂隙灯照相试验组滤过泡的高度、弥散范围、血管生长的评分上都显著优于对照组。UBM扫描显示试验组滤过泡的形态独特,为薄壁隆起状,滤过通道存在和泡内低反射的比率高于对照组(滤过通道89%比80%,泡内低反射74%比55%)。结论可注射式交联透明质酸钠可在一定程度上减少术后并发症、维持滤过泡形态和控制术后眼压;且其功能性滤过泡的形态较为独特。Objective To investigate the effect of injectable crosslink sodium hyaluronate in trabeculectomy.Methods Patients were divided into two groups with 25 patients in each group.One group received sub-conjunctiva injection of crosslink sodium hyaluronate after the surgery; the other group received regular surgery without injection. The post operation complications were observed. The intraocular pressure of each group at 1 week, 1 month, 3 months and 6months after operation were recorded. The blebs were evaluated by the slit lamp photographs, all the blebs were scanned by ultrasound biomicroscopy; the filtering canal, intrableb reflection and the form of the blebs were analyzed.Results The experimental group occurred less complication. The intraocular pressure of the two groups showed significant difference at 3 and 6 months; but no significant difference at 1 week and 1 month.The blebs in experimental group were characterized by better scores of height, extent, and vessels in slit lamp evaluation. The blebs in experimental group showed unique form of thin wall, the filtering canals were easily to detect （89vs80%）, and usually demonstrated a low reflection （74%vs55%）.Conclusion The injectable crosslink sodium hyaluronate can lessen the post-operation complications, maintain the form of the bleb and help to control the intraocular pressure. The appearance of the functional blebs had special characteristics.

关 键 词：小梁切除术 透明质酸钠 超声生物显微镜 

分 类 号：R779.6[医药卫生—眼科]