原发性闭角型青光眼行小梁切除术中应用可调整缝线的对照研究  

Comparative study on the application of adjustable suture in trabeculectomy for patients with primary angle-closure glaucoma

作　　者：谢瞻[1] 张娇 杜牧龙 陈琴[1] Xie Zhan;Zhang Jiao;Du Mulong;Chen Qin(Department of Ophthalmology,Jiangsu Province Hospital,Nanjing 210029,China;Department of Ophthalmology,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China;Department of Health Services at Nanjing Medical University,School of Public Health,Nanjing 210029,China)

机构地区：[1]江苏省人民医院眼科,南京210029 [2]昆明医科大学第一附属医院 [3]南京医学大学公共卫生学院

出　　处：《临床眼科杂志》2020年第2期108-112,共5页Journal of Clinical Ophthalmology

摘　　要：目的评估可调整缝线在原发性闭角型青光眼(PACG)患者行小梁切除术中应用的价值。方法来自江苏省人民医院眼科住院的PACG患者50例(50只眼)。随机分为小梁切除术联合可调整缝线组(25只眼)和传统小梁切除术组(25只眼)。术后1 d、7周、1个月、3个月、6个月随访。行LogMAR视力表检查视力、Goldmann压平眼压计测量眼压。眼压控制成功指在末次随访时未使用降眼压药物眼压<21 mm Hg;条件成功指在末次随访时在联合使用降眼压药物情况下眼压<21 mm Hg。主要指标为眼压、眼压控制成功率、并发症。结果术后1 d、术后1周、术后1个月、术后3个月、术后6个月两组眼压统计学意义(均P>0.05)。小梁切除术联合可调整缝线组眼压控制总成功率84%(21/25),低于改良小梁切除术组96%(24/25),差别无统计学意义(P>0.05);术后浅前房、脉络膜脱离、低眼压等发生率两组相似。改良小梁切除术组术后降眼压药物使用数量低于联合可调整缝线的小梁切除术组(P<0.05)。结论改良小梁切除术术后6个月的总成功率略高于联合可拆除缝线术的小梁切除术,两组并发症发生率相当。Objective To study the application of adjustable suture in trabeculectomy for patients with primary angle-closure glaucoma.Methods Fifty inpatients(50 eyes)with primary angle-closure glaucoma from our hospital were enrolled in this study.Patients were randomly assigned to the trabeculectomy with adjustable suture group(n=25)and the traditional trabeculectomy group(n=25).Intraocular pressure(IOP)measured by Goldmann applanation tomometer,LogMAR visual acuity,and surgical complications were recorded during the follow-up visits at 1 day,1 week,1 month,3 months and 6 months after the surgery.Successful IOP control was defined as an IOP of<21 mmHg without medication treatment at the last follow-up visit,and conditional successful IOP control was defined as an IOP of<21 mmHg with medication treatment at the last follow-up visit.Main outcomes included IOP,rate of successful IOP control,and surgical complications.Results There were no significant differences between the two groups in post-operative IOP at 1 day,1 week,3 months and 6 months(all P>0.05).The total success rate was 85%(21/25)in the adjustable suture group,which was lower than the traditional trabeculectomty group(96%,24/25)(P>0.05).The incidence of surgical complications,including shallow anterior chamber,choroidal detachment and low IOP,was similar between the two groups.The number of postoperative IOP-lowering medications in the traditional trabeculectomy group was less than the adjustable suture group(P<0.05).Conclusions The total success rate of the modified trabeculectomy was slightly higher than trabeculectomy combined with adjustable suture after 6 months postoperatively,and the incidence of surgical complications in the two groups was similar.

关 键 词：小梁切除术 可调整缝线 滤过量 原发性闭角型青光眼 

分 类 号：R73[医药卫生—肿瘤]