复合式与单纯小梁切除术治疗青光眼的临床对比观察  

Clinical comparison of compound and pure trabeculectomy in treatment of glaucoma

作　　者：黄宝玲[1] 王全志[2] 陈瑞合[1] 赵向阳[1] 张桂[1] 

机构地区：[1]漯河市中心医院眼科,河南省漯河市462000 [2]新乡医学院第三附属医院病理科,河南省新乡市453003

出　　处：《眼科新进展》2011年第9期875-877,共3页Recent Advances in Ophthalmology

摘　　要：目的比较复合式小梁切除术和单纯小梁切除术治疗青光眼的临床疗效。方法将70例(84眼)青光眼患者随机分为2组:复合式小梁切除术组35例(41眼),单纯小梁切除术35例(43眼)。复合式小梁切除术组术中联合应用丝裂霉素C和可调节缝线,其他手术操作步骤与单纯小梁切除术组基本相同。比较分析2组术后前房形成、眼压、滤过泡等情况。结果复合式小梁切除术组2眼(4.88%)在拆除可调节缝线后出现浅前房,单纯小梁切除术组有12眼(27.91%)发生浅前房,2组浅前房发生率差异有统计学意义(P<0.05)。2组患者出院时眼压均控制在21mmHg(1kPa=7.5mmHg)以下;术后6个月时,复合式小梁切除术组眼压<21mmHg共38眼(92.68%),单纯小梁切除术组共29眼(67.44%),2组眼压控制率差异有统计学意义(P<0.05)。2组患者出院时均形成功能性滤过泡;术后6个月时,复合式小梁切除术组37眼(90.24%)形成功能性滤过泡,单纯小梁切除术组30眼(69·77%),2组功能性滤过泡形成率差异有统计学意义(P<0.05)。结论复合式小梁切除术可有效减少术后浅前房的发生,在控制远期眼压和功能性滤过泡形成方面疗效显著,提高了手术成功率。Objective To observe the clinical effect of compound and pure trabeculectomy on glaucoma.Methods Seventy cases（84 eyes） with glaucoma were randomly divided into two groups,compound trabeculectomy group（35 cases,41 eyes） and pure trabeculectomy group（35 cases,43 eyes）.The mitomycin C and adjustable sutures were used in compound trabeculectomy,other operations were same as the pure trabeculectomy.The anterior chamber depth,intraocular pressure（IOP） and filtering bleb were compared postoperatively.Results The shallow anterior chamber appeared in 2 eyes（4.88%） in compound trabeculectomy group after the adjustable sutures were demolished,and 12 eyes（27.91%） in pure trabeculectomy group,there was statistical difference in the incidence of shallow anterior chamber between two groups（P0.05）.The IOP of two groups all controlled below 21 mmHg（1 kPa=7.5 mmHg） when they leaved hospital,but 6 months after operation,the IOP below 21 mmHg appeared in 38 eyes（92.68%） in compound trabeculectomy group,and 29 eyes（67.44%） in pure trabeculectomy group,there was statistical difference in IOP controlled rate between two groups（P0.05）.The functional filtering bleb of two groups were all formed when they leaved hospital,but 6 months after operation,the functional filtering bleb formed in 37 eyes（90.24%） in compound trabeculectomy group,and 30 eyes（69.77%） in pure trabeculectomy group,there was statistical difference in the forming rate of functional filtering bleb between two groups（P0.05）.Conclusion The compound trabeculectomy can effectively reduce the occurrence of postoperative shallow anterior chamber and have long term effect of IOP controlling and functional filtering blebs forming,and improve the success rate of operation.

关 键 词：青光眼 复合式小梁切除术 可调节缝线 

分 类 号：R775[医药卫生—眼科]