复合式小梁切除术治疗开角型青光眼临床观察  

Clinic Observation of the effect of Compound trabeculectomy on patients with open-angle glaucoma

作　　者：孙晓萍[1] 王静[1] 李海威[1] 朱冬梅[1] 

机构地区：[1]郑州市中心医院眼科,郑州市450007

出　　处：《中国实用眼科杂志》2016年第5期411-414,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 观察在经典小梁切除术中运用可调节缝线联合抗瘢痕药物丝裂霉素C（复合式小梁切除术）治疗原发性开角型青光眼的临床疗效.方法 临床病例对照研究.将2012年1月～2014年1月在郑州市中心医院眼科确诊为原发性开角型青光眼,并先后行双眼抗青光眼手术所有患者56例（112只眼）纳入研究.将所有患者的右眼（共56只眼）纳入观察组,行复合式小梁切除术;所有患者的左眼（共56只眼）纳入对照组,仅行经典小梁切除术.术后随访12个月,观察眼压、滤过泡形态、前房及并发症情况.结果 眼压：观察组完全成功52只眼,条件成功3只眼,失败1只眼,总有效率为98.2％ （55/56）;对照组完全成功39只眼,条件成功4只眼,失败13只眼,总有效率为76.8％（43/56）.两组比较差异有统计学意义（x2=-3.268,P＜0.05）.滤过泡：观察组36只眼Ⅰ型,15只眼Ⅱ型,3只眼Ⅲ型,2只眼Ⅳ型,功能性滤过泡91.1％ （51/56）;对照组30只眼Ⅰ型,11只眼Ⅱ型,9只眼Ⅲ型,6只眼Ⅳ型,功能性滤过泡73.2％ （41/56）.两组间差异具有统计学意义（x=-2.456,P ＜0.05）.观察组中并发症少.结论 复合式小梁切除术可以有效提高原发性开角型青光眼手术成功率,且并发症少.Objective To evaluate the clinical effect of combined surgery of classic trabeculectomy with adjustable suture and amniotic membrane implantation （compound trabeculectomy） on patients with open-angle glaucoma.Methods This study comprised fifty-six patients （112 eyes） that had open-angle glaucoma admitted into our hospital between January 2012 and January 2014.The right eyes of these fifty-six patients （56 eyes） were randomly included in the observation group （fifty-six patients,56 eyes） treated with the compound trabeculectomy and the left eyes in the control group （fifty-six patients,56 eyes） treated with classic trabeculectomy alone,respectively.Postoperatively,the intraocular pressure （IOP）,filtering bleb morphology,anterior chamber and complications were recorded.The follow-up time was at least 12 months after surgery.Results IOP of 52 eyes,3 eyes and 1 eye achieved complete success,conditional success and failure in the observation group,respectively,and the total success rate was 98.2% （55/56）.IOP of 39 eyes,4 eyes and 13 eyes achieved complete success,conditional success and failure in the control group,respectively,and the total success rate was 76.8%（43/56）.The difference of IOP between groups was statistically significant （x2=-3.268,P 〈0.05）.Thirty-six eyes,15 eyes,3 eyes and 2 eyes formed type Ⅰ,Ⅱ,Ⅲ and Ⅳ filtering bleb in the observation group,respectively,and the formation rate of functional filtering bleb was 91.1%（51/56）.Thirty eyes,11 eyes,9 eyes and 6 eyes formed type Ⅰ,Ⅱ,Ⅲ and Ⅳ filtering bleb in the control group,respectively,and the formation rate of functional filtering bleb was 73.2%（41/56）.The difference between groups was statistically significant （x2 =-2.456,P 〈0.05）.There was less complications in the observation group.Conclusions Compound trabeculectomy might effectively increase success rate of surgery for angle-closure glaucoma with less complications.

关 键 词：小梁切除术 可调节缝线 抗瘢痕药物 开角型青光眼 

分 类 号：R775.2[医药卫生—眼科]