激光辅助深层巩膜切除术治疗开角型青光眼的效果  

Efficacy of laser-assisted deep sclerectomy surgery for open angle glaucoma

作　　者：张恒丽[1] 唐广贤[1] 李凡[1] 马丽华[1] 闫晓伟[1] 耿玉磊[1] Zhang Hengli, Tang Guangxian, Li Fan, Yah Xiaowei, Ma Lihua, Geng Yulei(Department of Glaucoma, The First Hospital of Shijiazhuang City, The First Eye Hospital of Shijiazhuang City, Shijiazhuang 050000, Chin)

机构地区：[1]石家庄市第一医院青光眼科石家庄市第一眼科医院,石家庄050000

出　　处：《中华眼外伤职业眼病杂志》2018年第3期203-207,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价CO2激光辅助深层巩膜切除术治疗开角型青光眼的效果。方法回顾性分析2016年1月至2017年3月开角型青光眼连续病例61例（76眼）的临床资料，随机分为观察组和对照组。观察组进行CO2激光辅助深层巩膜切除术，共27例（32眼），其中男20例（23眼），女7例（9眼），平均年龄（47．22±11．15）岁。对照组进行传统小梁切除术，共34例（44眼），其中男23例（32眼），女11例（12眼），平均年龄（47．60±14．51）岁。比较两组患者手术效果。结果随访8～15个月，平均（9．10±2．40）个月。观察组和对照组术前眼压分别为（36．78±6．36）mmHg和（37．50±5．30）mmHg（1mmHg=0．133kPa），两组间差异无统计学意义（P=0．609）。术后6个月，两组眼压分别为（15．86±2．85）mmHg和（16．61±3．31）mmHg，差异无统计学意义（P=0．611），但均较术前降低（P〈0．05）。观察组术后1周滤过泡弥散隆起；术后1个月共存型及内滤过型占84．38％，外滤过型占12．50％；至末次随访，外滤过型均转变为共存型。术后6个月，观察组功能滤过泡较对照组少（P=0．040），手术成功率分别为87．96％和79．54％，差异无统计学意义（P=0．395）。术后早期，观察组睫状体浅脱离1眼，占3．13％；对照组前房延缓形成、前房积血及脉络膜脱离等共20眼，占45．45％。两组并发症比较差异有统计学意义（x^2=16．600，P=0．000）。结论CO2激光辅助深层巩膜切除术治疗开角型青光眼安全有效，术后早期并发症少，房水引流途径以内引流为主。Objective To evaluate the efficacy of CO2 laserassisted deep sclerectomy surgery for the treatment of open angle glaucoma. Methods The data of 76 eyes of 61 patients with open angle glaucoma from Jan. 2016 to Mar. 2017 were collected and analyzed retrospectively. All cases were randomly divided into observed group and control group. Observed group, 32 eyes of 27 cases, received CO2 laser- assisted deep sclereetomy surgery. In observed group, there were 23 eyes of 20 males and 9 eyes of 7 females. The average age was （47.22 ±11. 15） years. The control group, 44 eyes of 34 cases, underwent traditional trabeculectomy. There were 32 eyes of 23 males and 12 eyes of 11 females, the average age was （47.60 ± 14.51 ） years in control group. The efficacy between the two groups were compared. Results The follow - up period was 8 - 15 months, average （ 9.10± 2.40 ） months. The preoperative IOP in observed group and control group was （ 36.78 ± 6.36） mmHg and （ 37.50 ± 5.30） mmHg （ 1 mmHg = 0. 133 kPa）, respectively. The difference was not significant between the two groups （P = 0. 609 ）. Six months after surgery, lOP were （ 15.86 ± 2.85 ） mmHg and （ 16.61 ± 3.31 ） mmHg in observed group and control group, respectively. The difference was not statistically significant between the two groups （P = 0. 611 ）. IOP after surgery were lower than that before surgery （ P 〈 0.05 ）. In observed group, the functional bleb was diffused and swelling 1week after surgery. One month after surgery, the function bleb with the coexistent modality and internal filtering type accounted for 84.38% , the external filtering accounted for 12.50%. At the last follow-up, the modality of filtering bleb was converted from the external filtering to the coexisting form. The functional bleb 6 months after surgery in the observed group was smaller than that in the control group （P =0. 040）. The success rate was 87.96% and 79.54% in observed group and control group respectively （P= 0. 395）. Early post

关 键 词：青光眼 开角型 巩膜切除术 深层 CO2激光辅助 

分 类 号：R779.6[医药卫生—眼科]