微导管引导的360°小梁切开术治疗先天性青光眼的疗效  

The effect of 360°trabeculectomy assisted by microcatheter in the treatment of congenital glaucoma

作　　者：李思媛[1] 郑广营 郑娟 赵栋栋 高建鲁[1] Li Si-yuan;Zheng Guang-ying;Zheng Juan(Liaocheng people's hospital,Liaocheng 252000,China)

机构地区：[1]聊城市人民医院,252000

出　　处：《中国斜视与小儿眼科杂志》2020年第2期12-13,I0003,I0004,共4页Chinese Journal of Strabismus & Pediatric Ophthalmology

基　　金：山东省自然科学基金(编号:ZR2019PH050)。

摘　　要：目的评价微导管引导的360°小梁切开术对先天性青光眼的疗效和安全性.方法回顾性研究,收集2017年3月至2019年1月在聊城市人民医院行微导管引导的360°内路小梁切开术原发性先天性青光眼20例(25眼),分为两组,婴幼儿型青光眼6例(8眼),青少年型青光眼14例(17眼),并进行基因型的检测,比较术前与术后眼压、降眼压药物使用情况、眼前段情况及术后并发症.结果所有患者术前平均眼压(40.69±13.73)mmHg,术后1天、1周、3个月的平均眼压分别为(15.85±7.05)mmHg、(15±6.08)mmHg、(17±5.10)mmHg,均明显低于术前(P<0.001).术前平均应用(2.67±0.65)种药物,术后3个月平均应用(0.33±0.71)种药物,明显少于术前(P<0.001).两种基因突变型术后眼压均有降低.术后主要并发症为前房积血.结论微导管引导的360°小梁切开术对先天性青光眼均有较好的降眼压效果和良好的安全性.Objective To evaluate the efficacy and safety of 360° trabeculectomy assisted by microcatheter in the treatment of congenital glaucoma.Methods A retrospective study was carried out on 20 patients(25 eyes) with primary congenital glaucoma treated by 360° internal trabeculectomy assisted by microcatheter in Liaocheng people’s Hospital from M arch 2017 to January 2019.Patients were included two categories:6 cases(8 eyes) of infantile glaucoma and 14 cases(17 eyes) of juvenile glaucoma.The intraocular pressure(IOP),dosage of IOP-lowering medication and anterior segment condition before and after surgery as well as the surgery complications were compared.Results The mean pre-operation IOP was(40.69±13.73) mmHg,whereas the mean post-operation IOP at one day,one week and three months was(15.85±7.05) mmHg,(15±6.08) mmHg,(17±5.10) mmHg,respectively.The mean IOP at one day,one week and three months after operation was significantly lower than the pre-operation IOP(P<0.001).The average number of agent types after operation(0.33±0.71) was significantly less than that of pre-operation(2.67±0.65)(P<0.001).Hyphema in anterior chamber was the main complication of these surgeries.Conclusion The 360°trabeculectomy assisted by microcatheter has a satisfied effect on IOP reduction and safety.

关 键 词：微导管引导的小梁切开术 先天性青光眼 婴幼儿型青光眼 青少年型青光眼 

分 类 号：R779.6[医药卫生—眼科]