原发性闭角型青光眼小梁切除术中两种巩膜瓣可调整缝线的疗效比较  

Comparison of efficacy of two scleral flap adjustable sutures in primary angle-closure glaucoma trabeculectomy

作　　者：吴佐全 WU Zuoquan(Department of Ophthalmology,Sanming First Hospital Affiliated to Fujian Medical University,Sanming 365000,China)

机构地区：[1]福建医科大学附属三明第一医院眼科,福建三明365000

出　　处：《中国现代医生》2021年第29期92-95,共4页China Modern Doctor

摘　　要：目的探讨原发性闭角型青光眼小梁切除术中两种巩膜瓣可调节缝线的临床疗效。方法选取2018年1月至2020年6月在我院眼科手术治疗的原发性闭角青光眼患者43例(60眼)作为研究对象,随机分为对照组与观察组,每组各30眼,对照组采用小梁切除术联合巩膜瓣两侧缝合1对可调整缝线,观察组采用小梁切除术联合巩膜瓣鼻侧后角及中部各缝合1针可调整缝线。定期随访3个月比较两组并发症发生率、术后眼压控制情况及手术成功率。结果两组术后浅前房、脉络膜脱离的并发症总发生率比较,差异无统计学意义(P>0.05)。观察组在术后1 d、1个月、3个月眼压均低于对照组,差异有统计学意义(P<0.05)。观察组在术后7 d、术后2周眼压均低于对照组,但差异无统计学意义(P>0.05)。观察组术后3个月的手术成功率为96.67%(29/30),高于对照组的73.33%(22/30),差异有统计学意义(P<0.05)。结论在原发性闭角型青光眼小梁切除术中联合利用改良巩膜瓣可调整缝线技术是安全有效的,与传统的巩膜瓣可调整缝线相比提高了术后3个月的手术成功率。Objective To investigate the clinical efficacy of two scleral flap adjustable sutures in primary angle-closure glaucoma trabeculectomy.Methods A total of 43 patients(60 eyes)with primary angle-closure glaucoma treated in the Department of Ophthalmology of the Sanming First Hospital from January 2018 to June 2020 were selected.They were randomly divided into the control group and the observation group,with 30 eyes in each group.The control group were treated with trabeculectomy combined with 1 pair of adjustable sutures on both sides of the scleral flap,and the observation group were treated with trabeculectomy combined with 1 pair of adjustable sutures on the nasal posterior corner and middle of the scleral flap.Both groups were followed up regularly for 3 months to compare the incidence of complications,postoperative intraocular pressure control and success rate of surgery.Results There was no significant difference in the total incidences of complications of shallow anterior chamber and choroidal detachment in the two groups after surgery(P>0.05).1 day,1 month and 3 months after surgery,the intraocular pressures of the observation group were lower than those of the control group,with statistically significant differences(P<0.05).7 day and 2 weeks after surgery,the intraocular pressures in the observation group were lower than those in the control group,but without statistically significant differences(P>0.05).3 months after surgery,the success rate in the observation group was 96.67%(29/30),which was higher than that of 73.33%(22/30)in the control group,with statistically significant difference(P<0.05).Conclusion The combined use of modified scleral flap adjustable suture technique in primary angle-closure glaucoma trabeculectomy is safe and effective.Compared with the traditional scleral flap adjustable suture,it improves the success rate of surgery at 3 months after surgery.

关 键 词：小梁切除术 可调整缝线 原发性闭角型青光眼 巩膜瓣 

分 类 号：R775.2[医药卫生—眼科]