巩膜池小梁切除术治疗原发性青光眼的疗效  

Curative Effect of Scleral Concave Pool Trabeculectomy on Primary Glaucoma

作　　者：廖洪斐[1] 王俊勇 张向荣[3] 庞云[1] 

机构地区：[1]南昌大学第三附属医院眼科,南昌330008 [2]樟树市人民医院眼科,江西樟树331200 [3]南昌大学第一附属医院眼科,南昌330006

出　　处：《南昌大学学报（医学版）》2011年第1期41-44,共4页Journal of Nanchang University：Medical Sciences

摘　　要：目的探讨巩膜池小梁切除术治疗原发性青光眼的临床疗效。方法将60例(60眼)原发性青光眼患者按不同的手术方法分为3组:A组、B组和C组,每组20例(20眼)。A组行巩膜池小梁切除术,B组行丝裂霉素C(MMC)+小梁切除术,C组行常规小梁切除术。术后随访1周,3、6、12、24个月;观察3组患者术后眼压、滤过道大小、视野的变化及有无并发症发生等情况。结果 A、B 2组术后3、6、12、24个月眼压均明显低于C组(均P<0.05)。术后24个月,A、B 2组功能性滤过泡所占比例与C组比较差异均有统计学意义(均P<0.05),A组以Ⅱ型滤过泡为主,B组以I型滤过泡为主,C组Ⅲ型滤过泡为主;B、C 2组滤过道(减压室)值与A组比较差异均有统计学意义(均P<0.05);A、C 2组角膜上皮损伤、前房积血、滤过泡漏、前葡萄膜炎发生率均明显低于B组(P<0.05或P<0.01),B、C 2组浅前房发生率均明显低于A组(均P<0.05)。结论巩膜池小梁切除术能有效增加滤过道的大小,充分发挥减压功效,并能长期、有效控制眼压,且并发症少。Objective To explore the curative effect of scleral concave pool trabeculectomy on primary glaucoma.Methods Sixty patients with primary glaucoma（60 eyes） were divided into three groups,with 20 eyes in each group.Scleral concave pool trabeculectomy was performed in group A,scleral concave pool trabeculectomy with mitomycin C in group B,and routine trabeculectomy in group C.Patients were followed up for 1 week,3,6,12 and 24 months.The postoperative intraocular pressure,filtration path,visual field changes,and complications were observed.Results Intraocular pressure in group A and group B was significantly lower than that in group C 3,6,12 and 24 months after operation（all P0.05）.The proportions of functional filtering blebs in group A and group B were statistically different from those in group C 24 months after operation（all P0.05）.Type Ⅱ blebs were mainly present in group A,typeⅠ blebs in group B,and type Ⅲ blebs in group C.The values of filtration path（decompression chamber） in group B and group C were different from those in group A（all P0.05）.Compared with group B,incidences of corneal epithelium damage,anterior chamber hemorrhage,filtration bleb leak and anterior uveitis significantly decreased in group A and group C（P0.05 or P0.01）.Compared with group A,the incidence of shallow anterior chamber obviously decreased in group B and group C（all P 0.05）.Conclusion Sclera concave pool trabeculectomy can effectively increase the size of filtration path and led to long-term intraocular pressure control with less complications.

关 键 词：原发性青光眼 巩膜池小梁切除术 滤过道 疗效 

分 类 号：R775.2[医药卫生—眼科]