羊膜植入在非穿透性小梁切除术中的应用  

Implication of Non-perforating Deep Sclerectomy with Amniotic Membrane Implantation for Primary Open-angle Glaucoma

作　　者：叶纹[1] 孙静芬[1] 钟一声[1] 

机构地区：[1]上海第二医科大学附属瑞金医院眼科,上海200025

出　　处：《眼科学报》2002年第2期76-79,共4页Eye Science

摘　　要：目的:评价非穿透性小梁切除（Non-perforating deep sclerectomy,NPDS）联合羊膜植入术治疗原发性开角型青光眼（Primary open-angle glaucoma,POAG）的效果。方法:对14例23眼POAG分别进行NPDS联合羊膜植入术,术中巩膜瓣下放置0.04％丝裂霉素（Mitomycin C,MMC）4 min,并于巩膜瓣下植入6 mm×9 mm羊膜植片。结果:术后1个月,眼压≤21 mmHg者23眼,总成功率为 100％;随访3个月及以上者20眼,完全成功率达90％,部分成功率达100％;随访6个月及以上者11眼,完全成功率为72.7％,部分成功率达 100％,手术前后视力无明显变化;随访12个月及以上者6眼,成功率为 66.7％。所有眼压控制良好的患眼滤过泡形成良好,且无严重并发症发生。结论:羊膜是NPDS术中安全和有效的辅助植入材料。Purpose: To evaluate the efficacy of non-perforating deep sclerectomy(NPDS) with amniotic membrane implantation for primary open-angle glaucoma (POAG). Methods: Fourteen cases(23 eyes) of POAG underwent NPDS with amniotic membrane implantation. NPDS was performed with a fornix-based conjunctival flap using 0. 04% mitomycin C (MMC) under the scleral flap for 4 minutes. A 6 mm × 9 mm amniotic membrane was then placed under the scleral flap and sutured using 10-0 nylon. Results: One month postoperatively, the intraocular pressure (IOP) was less or equal to 21 mmHg in 23 eyes, with a total success rate of 100%. After 3 months of follow-up for 20 eyes, the completely success rate was 90%, and the partly success rate was 100%. After 6 months of follow-up for 11 eyes, the completely success rate was 72. 7%, the partly success rate was 100%, and the visual acuity had no significance between the pre-operation and post-operation. After 12 months of follow-up for 6 eyes, the success rate was 66. 7%. A good bleb formation was seen in the eyes and the IOP was controlled successfully. No serious complication was found in all eyes.Conclusion: Amniotic membrane is an effective and safe implantation material for NPDS.

关 键 词：非穿透性小梁切除术 羊膜植入 原发性开角型青光眼 

分 类 号：R779.6[医药卫生—眼科]