改良式小梁切除术在原发性急性闭角型青光眼中的应用  

Application of modified trabeculectomy in primary acute angle-closure glaucoma

作　　者：潘绍新 李薇 贾杨雪 汪鹏 夏璐 PAN Shaoxin;LI Wei;JIA Yangxue;WANG Peng;XIA Lu(Department of Ophthalmology,The Second Affiliated Hospital of Wannan Medical College,Wuhu 241000,Anhui,China)

机构地区：[1]皖南医学院第二附属医院眼科,安徽芜湖241000

出　　处：《皖南医学院学报》2025年第2期152-155,共4页Journal of Wannan Medical College

基　　金：皖南医学院中青年科研基金项目(EYR202201)。

摘　　要：目的:探究改良式小梁切除术在原发性急性闭角型青光眼中的应用。方法:选取2022年6月~2023年1月皖南医学院第二附属医院眼科收治并确诊为急性原发性闭角型青光眼患者36例(36只眼),随机分为改良组即小梁切除联合改良可调节缝线联合早期眼球按摩20例(20只眼),传统组即传统小梁切除术16例(16只眼)。比较两组术后早期前房形成、有效滤过泡占比、眼压水平及并发症发生率。结果:两组患者术后1周、1个月、6个月眼压均低于术前(P<0.05),改良组患者术后1周、1个月、6个月眼压均低于传统组(P<0.05)。传统组术后1周前房形成率为87.5%,改良组术后1周100.0%形成良好前房。改良组患者术后6个月随访功能性滤过泡形成率(100.0%)高于传统组(75.0%),P=0.031。两组患者均未出现脉络膜脱离、结膜瓣渗漏、爆发性脉络膜出血、恶性青光眼等严重并发症。结论:改良可调节缝线联合早期眼球按摩可有效降低术后早期浅前房及低眼压发生率,维持良好术后眼压及有效滤过泡。Objective:To investigate the application of modified trabeculectomy in the treatment of primary acute angle closure glaucoma.Methods:Thirty-six patients(36 eyes)with primary acute angle closure glaucoma,treated in our department between June 2022 and January 2023,were included and randomly allocated to modified group(n=20;20 eyes,treated by adjustable suture combined with early eyeball massage)and conventional treatment group(n=16;16 eyes,treated by routine trabeculectomy).The two groups were compared regarding the early anterior chamber formation,effective filtering bleb ratio,intraocular pressure level and complication rate after surgery.Results:The intraocular pressure in the two groups following operation was lower than that before operation at 1 week,1 month and 6 months(P<0.05),and the intraocular pressure was lower in modified group than in conventional group(P<0.05).The rate of anterior chamber formation in at 1 week after operation was 87.5%for the traditional group,and 100.0%for the modified group,and the rate of functional filter bubble formation was better in the modified group than in the conventional group by the follow-up at half a year after surgery(100.0%vs.75.0%,P=0.031).No serious complications,including choroidal detachment,conjunctival valve leakage,explosive choroidal hemorrhage,and malignant glaucoma,occurred in both groups.Conclusion:Modified adjustable sutures combined with early eyeball massage can effectively reduce the incidence of shallow anterior chamber and low intraocular pressure in the early postoperative period,and can maintain better postoperative intraocular pressure and effective filtering bleb.

关 键 词：小梁切除术 可调节缝线 眼球按摩 

分 类 号：R779.6[医药卫生—眼科]