生物羊膜联合减压阀植入术治疗新生血管性青光眼的中远期疗效分析  

Long-term effects of biological amnion combined with glaucoma valve implantation for neovascular glaucoma

作　　者：聂庆珠[1] 刘致力[1] 沙倩 高殿文[1] 

机构地区：[1]中国医科大学附属盛京医院眼科,沈阳110004 [2]黑龙江省眼病医院,哈尔滨150001

出　　处：《中华实验眼科杂志》2011年第3期265-268,共4页Chinese Journal Of Experimental Ophthalmology

基　　金：辽宁省科学技术计划项目（2009225021）

摘　　要：背景新生血管性青光眼是难治性青光眼之一，病因复杂，病情多变，疗效较差。羊膜联合减压阀植入术是目前治疗新生血管性青光眼的主要手术方法，其疗效一直受到眼科医师的关注。目的探讨羊膜联合减压阀植入术治疗新生血管性青光眼的中远期疗效。方法回顾性系列病例对照研究。收集分别施行羊膜联合减压阀植入术和单纯减压阀植入术患者的病例资料进行比较分析，2组纳入患者的年龄、性别和病因基本匹配，其中羊膜联合减压阀植入术组44例44眼，单纯减压阀植入术组43例43眼。患者随访24个月。手术成功的判断标准为术后眼压控制在21mmHg以内。结果随访期内，2组术后眼压均控制在21mmHg以内，术后1周2组患者的眼压差异无统计学意义（t=-5．34，P=0．60），术后3、12、24个月2组眼压比较，差异均有统计学意义（t=6．64、t=5．00、t=7．81，P〈0．01）。羊膜联合减压阀植入术组术后1周时的手术成功率为97．73％，术后3个月为93．18％，术后12个月为90．24％，术后24个月为82．05％。单纯减压阀植入术组术后1周手术成功率为95．35％，术后3个月为71．43％，术后12个月为65．00％，术后24个月为60．53％。术后3、12、24个月2组间手术成功率的差异均有统计学意义（χ^2=7．06、χ^2=7．47、χ^2=4．37，P〈0．05）。2组间术后前房出血、低眼压、引流管内口阻塞、脉络膜脱离、引流阀脱出的并发症发生率比较差异均无统计学意义（χ^2=0．12、χ^2=0．44、χ^2=0．18、χ^2=0．37、χ^2=0．00，P〉0．05）。结论羊膜联合减压阀植入术能较安全、有效地治疗新生血管性青光眼，特别是在中远期疗效上优于单纯减压阀植入术。Background Neovascular glaucoma is a type of refractory glaucoma. Biological amnion combined with glaucoma valve implantation is a primary therapy and its long-term effectiveness is noticeable. Objective The goal of this survey was to evaluate the effectiveness of biological amnion combined with glaucoma valve implantation for neovascular glaucoma and compare the clinical outcome with simple glaucoma valve implantation. Methods This was a retrospective observational case series. The clinical data of 44 eyes of 44 patients received biological amnion combined with glaucoma valve implantation for neovascular glaucoma and 43 eyes of 43 patients received simple glaucoma valve implantation for neovascular glaucoma were retrospectively analyzed and compared. The age, sex and disease-cause were matched between these two groups. Patients were followed-up for 24 months after operation. Surgery success was identified as the intraocular pressure （IOP） 〈 21 mmHg after operation. Written informed consent was obtained from each patient prior to the operation. Results The IOP was 〈 21 mmHg throughout the follow-up duration in both groups. No significant difference was found in the IOP value in 1 week after operation between two groups （t =-5.34 ,P = 0.60） . However, IOP values were lower in biological amnion combined with glaucoma valve implantation group in 3,12 and 24 months after operation than those of simple glaucoma valve implantation （t = 6.64, t = 5.00, t = 7.81, P〈0.01 ）. Operation successful rates in biological amnion combined with glaucoma valve implantation group were 97.73% ,93. 18% ,90.24% and 82.05% in 1 week,3 months, 12 months and 24 months respectively after operation, and those in simple glaucoma valve implantation were 95.35% ,71.43% , 65.00% and 60.53% in corresponding time points, showing considerably significant differences between two groups （χ^2 = 7.06,χ^2 = 7.47, χ^2 = 4.37, P 〈 0.05 ）. There was no significant difference in the number of eyes with complication between the two

关 键 词：生物羊膜 青光眼减压阀 青光眼/新生血管性 

分 类 号：R779.6[医药卫生—眼科]