外伤性青光眼引流阀植入术与小梁切除术的疗效对比  

The comparison of the efficacy between Ahmed drainage valve implantation and trabeculectomy for traumatic glaucoma

作　　者：姜蕾 邓珍 吴一峰 Jiang Lei;Deng Zhen;Wu Yifeng(Department of Ophthalmology,the First People’s Hospital of Yuhang District,Hangzhou 311100,China)

机构地区：[1]杭州市余杭第一人民医院眼科,杭州311100

出　　处：《中华眼外伤职业眼病杂志》2021年第3期194-198,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的比较Ahmed引流阀植入术与小梁切除术治疗外伤性青光眼的效果。方法前瞻性研究。选取2014年3月至2019年3月杭州市余杭第一人民医院外伤性青光眼120例(124眼),随机分为两组,A组60例(62眼),进行小梁切除术;B组60例(62眼),进行Ahmed引流阀植入术。术后随访12个月,比较两组手术疗效。结果两组治疗有效率相似(χ^(2)=0.472,P=0.492)。手术后3、6及12个月两组眼压、角膜内皮细胞密度均低于术前,手术后6及12个月B组眼压低于A组(t=7.285,5.640;均P<0.001);手术后3、6及12个月B组角膜内皮细胞密度高于A组(t=5.505,6.049,4.075;均P<0.001);B组并发症发生率低于A组(χ^(2)=5.447,P=0.020)。结论与小梁切除术比较,Ahmed引流阀植入术可有效提高外伤性青光眼患者的远期疗效,有利于控制眼压,且可减少角膜内皮损伤及并发症。Objective To compare the efficacy between Ahmed drainage valve implantation and trabeculectomy in the treatment of traumatic glaucoma.Methods This was a prospective study.A total of 124 eyes of 120 patients with traumatic glaucoma from Mar.2014 to Mar.2019 in the First People’s Hospital of Yuhang District were selected.They were randomly divided into two groups,including 62 eyes of 60 cases in group A and 62 eyes of 60 cases in group B.The group A underwent trabeculectomy,the group B underwent Ahmed drainage valve implantation.The efficacy were compared between the two groups.Results The effective rate of the two groups was similar(χ^(2)=0.472,P=0.492).The intraocular pressure and corneal endothelial cell density at 3,6 and 12 months after surgery in two groups were significantly lower than those before surgery.The intraocular pressure at 6 and 12 months after surgery in group B were significantly lower than those in the group A(t=7.285,5.640;P<0.001).The corneal endothelial cell density at 3,6 and 12 months after surgery in group B were significantly higher than those in group A(t=5.505,6049,4.075;P<0.001).The incidence of complications in group B was lower than that in the group A(χ^(2)=5.447,P=0.020).Conclusion Compared with trabeculectomy,Ahmed drainage valve implantation can effectively improve the long-term efficacy of patients with traumatic glaucoma,it is helpful to control the intraocular pressure,and reduce corneal endothelial injury and complications.

关 键 词：植入术 引流阀 小梁切除术 青光眼 外伤性 效果 

分 类 号：R779.6[医药卫生—眼科]