针刺分离联合结膜下注射5-氟尿嘧啶治疗包裹滤过泡  

Needle Revision Combined with 5-FU Subconjunctival Injection to Cure Dysfunctional Filtration Blebs

作　　者：童渝眉[1] 田雪莲 唐莉[2] Tong Yumei;Tian Xuelian;Tang Li(Chengdu Seventh People's Hospital,Chengdu,Sichuan 610021;West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]成都市第七人民医院眼科,四川成都610021 [2]四川大学华西医院眼科,四川成都610041

出　　处：《四川医学》2019年第8期801-802,共2页Sichuan Medical Journal

摘　　要：目的观察滤过泡针刺分离联合球结膜下5-Fu结膜下治疗青光眼滤过术后的包裹滤过泡的临床疗效。方法分析30眼行青光眼滤过手术术后发生滤过泡包裹并行针刺分离联合球结膜下5-Fu结膜下治疗的临床资料。其中22只眼为青光眼引流阀植入术后,8只眼小梁切除术后眼。以1mL注射针头针刺分离滤过泡周围的纤维瘢痕,联合球结膜下注射5-Fu,随访观察治疗前后视力、眼压、滤过泡形态、角膜内皮细胞计数及并发症情况。结果治疗前眼压为(33.30±5.40)mmHg,针刺分离后1天、1周、1个月、3个月眼压分别为:(12.00±2.59)mmHg、(14.97±3.26)mmHg、(20.20±4.17)mmHg、(18.17±2.36)mmHg,眼压明显下降(t=33.36,P<0.001)。治疗1个月时,8眼眼压超过21mmHg,需加用降压药物,3个月时有12眼需加用降压药。早期并发症主要有结膜下出血5例、角膜上皮点状剥脱2例,前房积血1例。结论滤过泡针刺分离联合球结膜下5-Fu注射治疗青光眼滤过术后的包裹滤过泡是一种安全、有效的挽救失败滤过泡的方法。Objectiue To observe the clinical effect of needle revision combined with subconjunctival injection of 5-FU to cure the dysfunctional filtration blebs after glaucoma filtration surgery.Methods Clinical materials of 30 eyes with dysfunctional filtration blebs underwent glaucoma filtration surgery has been analyzed,among which contains 22 eyes experienced aqueous shunts surgery and 8 eyes experienced trabeculectomy.Separate fiber tissues around the encapsulated filtering blebs with 1ml syringe needle and inject 5-FU subconjunctivally,then the visual acuity,intraocular pressure,morphology of filtering blebs,number of corneal endothelial cells and complications before and after surgery has been investigated.Results The average IOP before operation and 1 day,1 week,1 month and 3months after operation is( 33.30±5.40) mmHg,( 12.00±2.59) mmHg,( 14.97±3.26) mmHg,( 20.20± 4.17) mmHg,( 18.17±2.36) mmHg respectively.IOP after operation decreases notably.1 month after needle revision,8 eyes( IOP over 21mmHg) need medical interventions and 3 months later 12 eyes need interventions.Early complications mainly consist of subconjunctival hemorrhage( 5 eyes),exfoliation of corneal epithelium( 2 eyes) and hyphema( 1 eye).Conclusion Needle revision combined with subconjunctival injection of 5-FU to cure the dysfunctional filtration blebs after glaucoma filtration surgery is a safe and effective rescue for failure filtering blebs.

关 键 词：滤过泡包裹 青光眼 针刺分离 5-氟尿嘧啶 

分 类 号：R777.5[医药卫生—眼科]