小梁切除术后巩膜瓣缝线两种处理方法调控眼压的比较  

Comparison of the intraocular pressure lowering effect of laser Suture lysis versus adjustable suture for trabeculectomy

作　　者：白燕慧[1] 王卫群[1] 万晶晶[1] 孙广莉[1] BAI Yan-hui;WANG Wei-qun;Wan Jing-jing;SUN Guang-li(From the Department of Ophthalmology,the First AfiTliated Hospital of Zheng zhou University,Zhengzhou,Henan Province 450052,Chin)

机构地区：[1]河南省郑州大学第一附属医院眼科,450002

出　　处：《实用防盲技术》2018年第3期95-98,共4页Journal of Practical Preventing Blind

基　　金：国家自然科学基金资助(编号:81700798)

摘　　要：目的比较小梁切除术后激光断线和可调节缝线两种不同方法调控眼压的疗效。方法回顾性分析2014年12月-2016年5月在郑州大学第一附属医院就诊的原发性慢性闭角型和原发性开角型青光眼患者共47例(52眼),其中男性25例(28眼),女性22例(24眼)。将患者分为两组,A组行小梁切除联合巩膜瓣固定缝线缝合术,B组行小梁切除联合巩膜瓣可调节缝线缝合术,观察术前术后眼压和术后并发症;比较这两种不同方法调控眼压的疗效;结果小梁切除术前A组的眼压为29.5±6.8mm Hg,B组眼压为30.5±7.1mm Hg,两者比较差异无统计学意义(t=0.74,P>0.05),术后6个月A组眼压为12.3±5.5 mm Hg(1 kPa=7.5 mm Hg),B组眼压为13.7±6.3 mm Hg,两组的差异无统计学意义(t=0.46,P>0.05)。术后6个月2A组完全成功率为73.1%,B组完全成功率为84.6%,两组比较差异无统计学意义((χ~2=0.31,P>0.05)。术后浅前房、低眼压和脉络膜脱离的发生率A组较多,但两组比较差异无统计学意义(χ~2=0.15,χ~2=0.02,χ~2=0.02,P>0.05);结论小梁切除术后激光断线和可调节缝线均能有效的调控术后眼压,减少术后浅前房和低眼压等并发症,获得较理想的术后疗效。Objetive To compare the intraocular pressure（IOP） lowering effect of laser suture lysis and adjustable sutures for trabeculeetomy. Methods A total of 47 patients （52 eyes） with primary chronic angle closure glaucoma and primary angle open glaucoma in the First Affiliated Hospital of Zhengzhou University from December 2014 to May 2016 were retrospectively analyzed. There were 25 males （28 eyes） and 22 females （24 eyes）. IOP before treatment and post treatment were recorded as well as complications. The patients were divided into two groups. Group A received trabeeulectomy combined with scleral suture fixation, Group B received trabeculectomy combined with scleral flap adjustment sutures, and compared the effects of these two different methods on the regulation of intraocular pressure（lOP）. Results Intraoeular pressure（IOP） preoperative in both groups was similar （ t=0.74, P〉0.05 ）. Mean intraocular pressure was 12.3 ± 5.5 mmHg in the laser suture lysis group and 13.7± 6.3 mmHg in the adjustable suture group which was not significantly different 6 months postoperetively （ t=0.46, P〉0.05 ） . The Success rate was 73.1% in the laser suture lysis group versus 84.6% in the adjustable suture group and there was not significant difference（χ^2=0-31, P〉0.05 ） .We found more postoperative complications such as shallow chamber and hypotony ,cboroidal detachment in the laser suture lysis group but there was not significant difference. Conclusion Both the laser suture lysis and releasable suture techniques can obtain a better postoperative effect.

关 键 词：激光断线 可调节缝线 小梁切除术 

分 类 号：R779.6[医药卫生—眼科]