颞侧“W”形切口联合冷冻干燥羊膜在残余性青光眼的疗效观察  

Clinical Effects of Temporal Incision of "W" Form Combined with Freeze-dried Amniotic Membrane in Vestigial Glaucoma

作　　者：谭钢[1] 邵毅[2] 喻小龙[1] 王艳[1] 邓吕红[1] 刘二华[1] 

机构地区：[1]南华大学第一附属医院眼科,湖南衡阳421001 [2]南昌大学第一附属医院

出　　处：《中南医学科学杂志》2011年第4期410-412,共3页Medical Science Journal of Central South China

基　　金：湖南省科技计划项目资助(2010FJ4135)

摘　　要：目的评价"W"型切口联合冷冻干燥羊膜在残余性青光眼的临床效果。方法采用随机对照的方法,将40例(40眼)残余性青光眼分为实验组和对照组各20例(20眼),实验组行颞侧"W"形切口联合冷冻干燥羊膜手术,对照组行颞侧常规复合小梁切除手术,随访6～12月。对比观察两组间视力、角膜术源性散光、眼压、滤过泡、手术成功率及术后并发症等。结果实验组与对照组在功能性滤过泡的累积存活率、手术成功率、术后视力改善、术后并发症差异无显著性;两组形成的术源性散光,滤过泡差异有显著性。结论颞侧"W"形切口联合冷冻干燥羊膜治疗残余性青光眼,是一种理想的手术方式。Objective To evaluate the clinical effects of a novel surgery in vestigial glaucoma that use temporal incision of ＂W＂ form combined with freeze-dried amniotic membrane.Methods Twenty patients（20 eyes） with vestigial glaucoma treated with a second surgery.We made an anti superciliary arch sclera incision about 5 mm at half past ten behind corneal limbus,and prolonged the sclera incision to corneal limbus to form a sclera flap with ＂W＂ shape.Freeze-dried amniotic membrane was used to wrap the sclera flap to prevent hyperplasia of scar tissues.Results In the average follow-up period of more than 6 months,all the patients kept the same or increased visual acuity.Astigmatism induced by surgery gradually decreased in 3 months postoperatively.Average intraocular pressure decreased from 29.6 mmHg preoperatively to 18.9 mmHg postoperatively,success rate of this surgery was 85%.There were 19 functioning blebs（95%） under the slit lamp microscope,and among these functioning blebs,the number of Ⅰ and Ⅱ bleb were 17 eyes and 2 eyes respectively.Conclusions Temporal incision of ＂W＂ form combined with freeze-dried amniotic membrane can perfectly reduce intraocular pressure and prevent postoperative complications in vestigial glaucoma patients.

关 键 词：冷冻干燥羊膜 残余性青光眼 颞侧手术 “W”形切口 

分 类 号：R775.9[医药卫生—眼科]