可注射式交联透明质酸钠在小梁切除术中的作用  

Effect of injectable crosslink sodium hyaluronate in trabeculectomy

作　　者：付晶[1] 郝磊[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,北京市100730

出　　处：《眼科新进展》2011年第4期350-354,共5页Recent Advances in Ophthalmology

摘　　要：目的研究注射交联透明质酸钠后的滤过泡形态特征和作用。方法将患者随机分成2组,每组25例(25眼),其中一组在术毕滤过泡下注射交联透明质酸钠(试验组),另一组常规缝合结膜(对照组)。观察术后并发症;测量术后1周、1个月、3个月、6个月的眼压;采用各时间点裂隙灯照像评分作为参比标准,用前节OCT扫描滤过泡,观察滤过泡形态,并记录滤过泡的横径、纵径、高度、泡壁厚度。结果试验组在术后早期并发症较少。术后1周试验组眼压:(10.5±4.6)mmHg(1kPa=7.5mmHg),对照组(9.2±4.4)mmHg(P=0.305);术后1个月试验组眼压(9.7±2.7)mmHg,对照组(11.2±5.3)mmHg(P=0.221);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);术后6个月试验组眼压(11.6±4.9)mmHg,对照组(15.2±5.2)mmHg(P=0.037)。在各个时间点裂隙灯照像评分中试验组滤过泡的高度、弥散范围、血管生长都显著优于对照组。在各个时间点前节OCT扫描显示试验组滤过泡的横径、纵径、高度都显著大于对照组,泡壁厚度无显著差异,但是部分滤过泡显示为包裹型。结论注射交联透明质酸钠后滤过泡更加隆起、弥散,而泡壁厚度没有明显变化。注射交联透明质酸钠在一定程度上减少术后低眼压、浅前房和滤过泡瘢痕化等并发症的发生,且术后3～6个月时眼压控制较好。Objective To investigate the morphological features and effects of the blebs implanted with injectable crosslink sodium hyaluronate in trabeculectomy. Methods All patients were randomly divided into 2 groups,25 cases（25 eyes） in each group.The experimental group received sub-conjunctival injection of crosslink sodium hyaluronate after the operation;The control group received regular suturation of conjunctiva.The complications were observed after operation.The intraocular pressure of each group at 1 week,1 month,3 months and 6months after operation were recorded.We set the slit lamp photograph evaluation as standard,and scanned the blebs by anterior segment OCT.The transverse/longitudinal length,height and thickness of the bleb were recorded. Results The experimental group had fewer complications after operation.Intraocular pressures were（10.5±4.6）mmHg（1 kPa=7.5 mmHg） in experimental group and（9.2±4.4） mmHg in control group at 1 week after operation（P=0.305）,（9.7±2.7）mmHg in experimental group and（11.2±5.3）mmHg in control group at 1 month after operation（P=0.221）,（10.8±3.8）mmHg in experimental group and（13.8±6.3）mmHg in control group at 3 months after operation（P=0.047）,（11.6±4.9）mmHg in experimental group and（15.2±5.2）mmHg in control group at 6 months after operation（P=0.037）;The blebs in experimental group were characterized with better scores of height,extent and vessels in slit lamp evaluation.The blebs in experimental group showed longer transverse/longitudinal length and higher height measuring by anterior segment OCT at different time points,while the thickness of the bleb wall showed no significant difference,and some blebs shared the similar morphological features with the encapsulated filtering bleb. Conclusions The blebs implanted with sodium hyaluronate display raised and disperse features compared with the control group.However,the thickness of the bleb wall seems to be unchanged.The crosslink sodium hyaluronate can lessen the complicatio

关 键 词：透明质酸钠 小梁切除术 前节OCT 

分 类 号：R779.6[医药卫生—眼科]