非穿透板层小梁切除术联合丝裂霉素C与改良小梁切除术治疗原发性开角型青光眼的疗效比较  

Comparison of non-penetrating lamellar trabeculectomy with mitomycin C and modified penetrating trabeculectomy for primary open-angle glaucoma

作　　者：罗丹[1] 王林[1] 温跃春[1] 柯根杰[1] 

机构地区：[1]安徽省省立医院眼科,安徽省合肥市230001

出　　处：《眼科新进展》2011年第6期568-570,共3页Recent Advances in Ophthalmology

摘　　要：目的比较非穿透板层小梁切除术(nonpenetrating lamellar trabeculectomy,NPT)联合丝裂霉素C(mitomycin C,MMC)与改良小梁切除术治疗原发性开角型青光眼(primary open angle glaucoma,POAG)的有效性和安全性。方法回顾性分析37例(57眼)POAG患者应用NPT联合MMC治疗与30例51眼POAG患者行改良小梁切除术治疗的效果。观察并比较2组患者术后眼压、视力、成功率、并发症等。结果 NPT联合MMC治疗后POAG患者与经改良小梁切除术治疗后眼压在术后早期和中期无明显差异;术后24个月,经NPT联合MMC治疗,良好眼压控制成功率大约为47%,而经改良小梁切除术治疗,良好眼压控制成功率接近70%,术后6个月、12个月、18个月,2组眼压控制成功率比较差异均无统计学意义(均为P>0.05)。2组术后1周视力比较,差异无统计学意义;术后24个月视力比较,NPT联合MMC治疗组优于改良小梁切除术治疗组(P<0.05)。改良小梁切除术治疗组术后浅前房(14眼,27.5%)和白内障(11眼,21.6%)的发展率高于NPT联合MMC治疗组。结论 NPT联合MMC治疗在早期和中期控制眼压方面与改良小梁切除术疗效相当,但改良小梁切除术长期良好眼压控制成功率较高。NPT联合MMC治疗术后并发症少于改良小梁切除术后。Objective To compare the safety and efficacy of non-penetrating lamellar trabeculectomy（NPT）with mitomycin C（MMC）and modified penetrating trabeculectomy（PT）in the treatment of primary open-angle glaucoma（POAG）.MethodsThirty-seven patients（57 eyes）with POAG underwent NPT with MMC.The results were compared with those in 30 patients（51 eyes）treated with modified penetrating trabeculectomy（PT）.Intraocular pressure（IOP）measurement and slit-lamp examinations were performed before and after surgery：one time per week until to 1 month,one time per month until to 6 months and one time per 3 months until to 24 months.ResultsThere was no statistical difference in IOP at early and midterm stage after surgery between NPT and modified PT.The probability of success（good IOP control）was 47% with NPT and MMC,and 70% with PT.But the postoperative shallow anterior chamber（14 eyes,27.5%）and cataract progression（11 eyes,21.6%）occurred more frequently with modified PT than that with NPT and MMC.ConclusionsNPT with MMC surgery have a similar effect on controlling IOP at early and midterm stage after surgery,but the control success probability of IOP is better with modified PT surgery than those with NPT and MMC surgery.The rate of complication is lower with NPT and MMC surgery than that with modified PT surgery.

关 键 词：丝裂霉素C 原发性开角型青光眼 非穿透小梁切除术 改良小梁切除术 

分 类 号：R775[医药卫生—眼科]