改良小梁切除术联合羊膜移植治疗难治性青光眼  

Curative effects of improved trabeculectomy combined with amniotic membrane grafting on refractory glaucoma

作　　者：张启珍 罗顺利 王勤 

机构地区：[1]周口市眼科医院,河南省周口市466000

出　　处：《眼科新进展》2013年第4期381-383,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨改良小梁切除术联合羊膜移植治疗难治性青光眼的临床疗效。方法难治性青光眼患者32例(42眼),采用改良小梁切除术联合羊膜移植治疗,术后随访3～12个月,观察患者术后3个月、6个月的眼压、滤过泡、视力及并发症等情况。结果术后3个月、12个月眼压分别为(13.4±2.8)mmHg(1kPa=7.5mmHg)、(15.8±3.7)mmHg,与术前(35.6±6.3)mmHg相比,差异均有显著统计学意义(均为P<0.01)。术后3个月、6个月功能性滤过泡分别占90.5%、95.2%。术后3个月、6个月视力较术前均有不同程度提高,差异均有统计学意义(均为P<0.05)。术后仅4眼新生血管性青光眼由于滤过泡瘢痕化,经局部加用抗青光眼药物后眼压仍大于21mmHg;所有患眼均无明显并发症和羊膜移植排斥反应。结论改良小梁切除术联合羊膜移植治疗难治性青光眼疗效确切,并发症较少。Objective To investigate the clinical curative effects of improved trabeculectomy combined with amniotic membrane grafting on refractory glaucoma.Methods A total of 32 patients（42 eyes）with refractory glaucoma were treated with improved trabeculectomy combined with amniotic membrane grafting,follow up for 3-12 months and at postoperative 3 months and 6 months intraocular pressure,filtering bleb,visual acuity and complications were observed.Results At postoperative 3 months and 12 months,the intraocular pressure were（13.4±2.8）mmHg（1 kPa=7.5 mmHg）,（15.8±3.7）mmHg,respectively;Compared with preoperative intraocular pressure（35.6±6.3）mmHg,there were significant difference（both P0.01）.At postoperative 3 months and 6 months,the percentage of functional filtering bleb were 90.5% and 95.2%.The visual acuity at postoperative 3 months and 6 months both improved,there were significant difference compared with pre-operation（both P0.05）.Only the intraocular pressure of 4 eyes of neovascular glaucoma was still above 21 mmHg because of filtering bleb scarring after the treatment.All patients had no obvious complications and amniotic membrane grafting rejection.Conclusion The clinical curative effects of compound trabeculectomy combined with amniotic membrane grafting on refractory glaucoma are better with few complications,which should be applied in the primary hospital.

关 键 词：改良小梁切除术 羊膜移植 难治性青光眼 

分 类 号：R775[医药卫生—眼科]