两种非穿透性小梁手术联合网状透明质酸植入疗效比较  

Comparative studies of two non-penetrating trabecular surgery for reticulated hyaluronic acid implant

作　　者：叶天才[1] 冀建平[1] 张秀兰[1] 王宁利[1] 余敏斌[1] 刘杏[1] 陈秀琦[1] 

机构地区：[1]中山医科大学中山眼科中心,广东广州510060

出　　处：《眼视光学杂志》2001年第3期165-168,共4页Chinese Journal of Optometry & Ophthalmology

摘　　要：目的 :评价两种非穿透性小梁手术术后最初 3个月的临床效果。方法 :对 5 4例 6 2眼中、晚期开角型青光眼患者 ,采用非穿透性深层巩膜切除技术 (2 7眼 )和非穿透性深层巩膜切除加外部小梁切除技术 (35眼 ) ,比较两组术后眼压、视力、前房角表现和并发症。结果 :两组术后各时点平均眼压值均较术前降低 (P <0 .0 5 ) ;术后第 3个月的平均眼压分别是 (13.96± 5 .35 )mmHg和 (14.18± 3.5 1)mmHg,眼压下降幅度分别是 5 5 .0 8%和 45 .37% ;术后非穿透性深层巩膜切除加外部小梁切除组的平均眼压明显比单纯非穿透性深层巩膜切除组低 ,眼压下降幅度亦明显增加 (P <0 .0 5 )。两组术前和术后 3个月的视力差异无统计学意义 (P >0 .0 5 )。前房角表现为空腔型和宽带型者 ,非穿透性深层巩膜切除加外部小梁切除组占 77.1% ,而单纯深层巩膜切除组占 70 .4%。两组并发症较少并且类似。结论 :非穿透性小梁手术成功的关键是获得具有良好渗透功能的滤过膜 ,两种基础技术结合显著提高术后眼压下降的幅度和速率 。Objective:To evaluate and compare the clinical outcomes of two non penetrating procedures in the first 3 postoperative months.Methods:Of 62 eyes (54 patients) with middle to late stage open angle glaucoma, 27 eyes underwent non penetrating deep sclerectomy (NPDS) and 35 eyes underwent non penetrating deep sclerectomy plus non penetrating external trabeculectomy (NPDS+NPET). Postoperative IOP, visual acuity (VA), gonioscopic findings and complications in the 2 groups were compared.Results:The mean IOP in the two groups was lower postoperatively compared to preoperative measurements (P<0.05). On the first postoperative day, IOP in the NPDS+NPET group was lower than that for the NPDS group and the degree of IOP reduction in the NPDS+NPET group was greater. These differences were maintained until 3 months after surgery (P<0.05). At the end of 3 months postoperatively, the IOP reduction was 55.08% in the NPDS+NPET group and 45.37% in the NPDS group. The mean postoperative IOP in the two groups was (13.96+5.35)mmHg and (14.18+3.51)mmHg, respectively. The difference in preoperative and postoperative visual acuity for each group was not statistically significant with χ 2 test (P>0.05). The most common gonioscopic findings were transparent spaces and wide lunar configurations. These findings were confirmed in 70.4% of the cases for the NPDS group and 77.1% for the NPDS+NPET group. Complications were not frequently encountered in either group and occurrences were comparable.Conclusion:A functioning filtration membrane is critical for a successful non penetrating trabecular surgery. IOP was significantly reduced in the NPDS+NPET group while complications were not increased.

关 键 词：开角型青光眼 非穿透性小梁手术 深层巩膜切除 小梁切开术 网状透明质酸 

分 类 号：R779.6[医药卫生—眼科]