非穿透性小梁切除术治疗特殊类型青光眼的效果  

The efficacy of non-penetrating trabeculectomy for the treatment of special types of glaucoma

作　　者：马恩普[1] 汪洋[1] 张源[1] 郜文欣 买志彬[1] Ma Enpu;Wang Yang;Zhang Yuan;Gao Wenxin;Mai Zhibin(Department of Ophthalmology,the Hospital of Henan People’s Armed Police Forces,Zhengzhou 450052,China)

机构地区：[1]武警河南总队医院眼科,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2022年第8期623-627,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价非穿透性小梁切除术治疗特殊类型青光眼的安全性和有效性。方法回顾性病例对照研究。分析武警河南总队医院2019年1月至2020年12月特殊类型青光眼手术65例(76眼)的临床资料。青光眼类型包括无晶状体眼、人工晶状体眼、玻璃体切除术后灌注液填充眼或高度近视眼伴发青光眼,根据手术方式将患者分为两组:非穿透性小梁切除术组(治疗组)35例(41眼)和复合式小梁切除手术组(对照组)30例(35眼)。术后随访1年,观察两组的视力、眼压及并发症。结果治疗组术后1周及1个月时裸眼视力优于对照组(χ^(2)=5.86,4.30;P=0.018,0.038)。两组术后各时间点平均眼压均较术前明显降低,差异有统计学意义(P<0.05),两组间比较差异无统计学意义(P>0.05)。治疗组术后各时间点均无并发症发生;对照组术后1周内有11眼发生浅前房,其中3眼伴前房积血,2眼低眼压,1眼前房形成迟缓,均在术后2~4周内恢复正常。结论非穿透性小梁切除术治疗特殊类型青光眼较复合式小梁切除手术安全性高,降眼压效果显著。Objective To evaluate the safety and efficacy of non-penetrating trabeculectomy for the treatment of some special types of glaucoma.Methods This was a retrospective case control study.The clinical data of 76 eyes of 65 patients with special type of glaucoma in the Hospital of Henan People’s Armed Police Forces from Jan.2019 to Dec.2020 were analyzed.The type of glaucoma included aphakia eyes,artificial lens eyes,fluid-filled eyes(fluid filling after vitrectomy)or high myopia with glaucoma.The patients were divided into two groups,based on the surgical method.In the treatment group,41 eyes of 35 patients underwent non-penetrating trabeculectomy.In the control group,35 eyes of 30 patients underwent trabeculectomy combined with peripheral iridectomy.The follow-up time was 1 year after surgery.The visual acuity,intraocular pressure and complications in the two groups were observed.Results The uncorrected visual acuity of the treatment group was better than that of the control group at 1 week and 1 month after operation(χ^(2)=5.86,4.30;P=0.018,0.038).The average IOP at all postoperative time points in both groups were significantly lower than that before surgery(P<0.05),but there was no statistical significant difference between the two groups(P>0.05).There were no postoperative complications at any time points in the treatment group.In the control group,there were 11 eyes with shallow anterior chamber in 1 week after operation,including 3 eyes with hyphema,2 eyes with low intraocular pressure and 1 eye with delayed anterior chamber formation.All of them returned to normal within 2-4 weeks after operation.Conclusion Compared with compound trabeculectomy,non-penetrating trabeculectomy is a safe and effective treatment option in reducing IOP for some special types of glaucoma.

关 键 词：小梁切除术 非穿透性 青光眼 特殊类型 眼压 并发症 

分 类 号：R779.6[医药卫生—眼科]