改良小梁切除术联合丝裂霉素在新生血管性青光眼中的临床疗效评价  

The evaluation of clinical efficacy of modified trabeculectomy combined with mitomycin in the treatment ofneovascular glaucoma

作　　者：岳艳菊[1] 

机构地区：[1]河南省信阳职业技术学院附属医院信阳市第二人民医院眼科,464000

出　　处：《国际医药卫生导报》2013年第17期2742-2745,共4页International Medicine and Health Guidance News

摘　　要：目的评价改良小梁切除术联合丝裂霉素在新生血管性青光眼的临床疗效。方法选择我院收治的35例（35眼）新生血管性青光眼患者，予以控制眼压、血糖等措施后采取改良小梁切除术联合丝裂霉素进行治疗，术中应用可调节缝线，并针对患者的眼压及滤过泡来决定可调节缝线的拆除时间。并对35例患者术前及术后6个月的眼压、滤过泡、视力、前房深度及新生血管情况进行随访。结果35例患者（35眼）术后当日高眼压的症状及体征均消除。术后6个月，35例患者平均眼压为（15．8±7．2）mmHg，与术前的平均眼压（53.3±9．7）mmHg比较，眼压显著降低（P〈0．01）；功能性滤过泡约占88．6％；29例患者（29眼）视力较术前均存在程度不一的提高。35例患者（35眼）均保持良好的前房深度；虹膜新生血管全部消退约占31．4％，消退在50％以上约占48．6％，消退在50％以下约占20．0％。结论改良小梁切除术联合丝裂霉素治疗新生血管性青光眼，能有效重建房水循环路径，使患者的症状大大减轻，提高了手术的成功率及安全性。Objective To evaluate the clinical efficacy of modified trabeculectomy combined with mitomycin in the treatment of neovascular glaucoma. Methods 35 patients with neovascular glaucoma were given treatment of modified trabeculectomy combined with mitomycin after intraocular pressure and blood sugar were controlled. Removable sutures were applied during operation and removed according to the postoperative intraocular pressure and filtering blebs. Intraocular pressure, filtering blebs, sight, anterior chamber depth and neovascular conditions before and 6 months after operation were observed. Results Symptoms and signs of high intraocular pressure of all of the 35 patients（35 eyes） were cured on the day of operation. 6 months after operation, the average intraocular pressure was （15.8±7.2）mmHg, significantly different from preoperative （53.3±9.7）mmHg（P 〈 0.01）. Functional filtering blebs accounted for 88.6%, postoperative sight increased in varying degrees compared with preoperative in 29 patients （29 eyes）. All of the 35 patients（35 eyes） kept good anterior chamber depth. 31.4% of iris neovascularization totally eliminated, 48.6% eliminating more than 50%, 20.0% eliminating less than 50%. Conclusions Modified trabeculectomy combined with mitomycin can reconstruct aqueous humor circulation path, greatly reduce the symptoms of patients, and improve the success rate and safety in the treatment of neovascular glaucoma.

关 键 词：新生血管性青光眼 丝裂霉素 改良小梁切除术 临床疗效 

分 类 号：R779.6[医药卫生—眼科]